Causes
- low iron stores
  - ¼ - 1/3 is what the body stores – what is showed before the PT will show symptoms
- Chronic blood loss
- low iron intake
- Iron malabsorption
- Pregnancy blood flow increases iron, more O2 is needed --> depleted from the iron, usually told to take multivitamin because of this
- Alcoholics -- depleted iron as well because alcohol needs iron to digest, & they are usually malnourished as well
- Intrinsic factor in the GI but in bariatric SX – it may be lost
Clinical manifestations
- Smooth, sore tongue
- Brittle and ridged nails
- Angular cheilosis
Diagnostic findings
- Bone marrow aspiration
- low ferritin levels
- low MCV
- low HCT and RBC levels
Medical/Nursing Management
- Treat underlying cause
  - Bleeding (cancer, tumors)
  - Stool for occult blood
  - People over age of 50-> colonoscopy, endoscopy, or X-ray of GI tract
  - Celiac & gastric surgery -> inadequate iron absorption
- Iron supplements
  - GI side effects -> Use of Stool softeners
    - increases constipation because it is a hard supplement—important to be given a stool softener— increase in grains in diet to soften stool
    - Orange juice  absorption in the body
    - Increase the intake of vitamin C (citrus fruits and juices, strawberries, tomatoes, broccoli) to enhance iron absorption. Eat foods high in fiber to minimize problems with constipation; add stool softener if needed. Remember that stools will become dark in color.
    - Prevent staining the teeth with a liquid preparation by using a straw or placing a spoon at the back of the mouth to take the supplement. Rinse the mouth thoroughly afterward. PAGE 931
  - Take on empty stomach
    - Very important
- Increase iron in diet
  - Vitamin C sources enhances iron absorption