The nurse observes a co-worker who always seems to be eating a cup of ice. The nurse encourages the co-worker to have an examination and diagnostic workup with the health care provider. What type of anemia is the nurse concerned that the co-worker may have?

Reasoning:

Choice A reason: Weight loss is not a typical side effect of corticosteroid therapy for Addison’s disease. Corticosteroids mimic cortisol, promoting weight gain through increased appetite and fat redistribution. Weight loss is more common in untreated Addison’s disease due to cortisol deficiency and reduced appetite.

Choice B reason: Poor wound healing is a side effect of corticosteroids, as they suppress immune responses and inhibit collagen synthesis. This impairs fibroblast activity and tissue repair, increasing infection risk and delaying wound closure, a significant concern for patients on long-term therapy for Addison’s disease.

Choice C reason: Hypertension is a common side effect of corticosteroids due to their mineralocorticoid effects, which increase sodium and water retention, elevating blood volume and pressure. This is particularly relevant in Addison’s disease treatment, where corticosteroids restore deficient aldosterone and cortisol, potentially causing fluid overload.

Choice D reason: Hypotension is not a side effect of corticosteroid therapy but a symptom of untreated Addison’s disease due to aldosterone deficiency, causing sodium loss and hypovolemia. Corticosteroid therapy corrects this, so hypotension is unlikely unless under-dosed or during acute crisis.

Choice E reason: Alterations in glucose metabolism are a side effect of corticosteroids, which induce insulin resistance and increase gluconeogenesis, leading to hyperglycemia. In Addison’s disease, corticosteroids replace deficient cortisol, but excess dosing can mimic Cushing’s syndrome, causing elevated blood glucose and requiring careful monitoring.

Reasoning:

Choice A reason: Itching, rash, and jaundice are not typical of iron deficiency anemia. Jaundice suggests hemolysis or liver disease, and itching or rash may indicate allergic or dermatologic conditions. Iron deficiency causes reduced hemoglobin, leading to oxygen delivery issues, not these symptoms, making this incorrect.

Choice B reason: Night sweats, weight loss, and diarrhea suggest systemic conditions like malignancy or infection, not iron deficiency anemia. These symptoms are unrelated to low iron, which primarily causes fatigue and pallor due to reduced hemoglobin and oxygen-carrying capacity, not inflammatory or gastrointestinal symptoms.

Choice C reason: Dyspnea, tachycardia, and pallor are classic findings in iron deficiency anemia. Low hemoglobin reduces oxygen delivery, causing dyspnea and tachycardia as the body compensates. Pallor results from decreased red blood cell mass, reflecting the anemia’s impact on tissue oxygenation and circulation.

Choice D reason: Nausea, vomiting, and anorexia are not primary features of iron deficiency anemia. These gastrointestinal symptoms may occur with iron supplementation side effects or other conditions, but anemia itself causes fatigue, pallor, and dyspnea due to low hemoglobin, not digestive disturbances.