Pathophysiology of Iron Deficiency Anemia – week 7 Advanced Pathophysiology response 2

Pathophysiology of Iron Deficiency Anemia  – week 7 Advanced Pathophysiology response 2

Type of document           Essay

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Subject area         Nursing

Academic Level Master

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Number of references  4

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Please respond to Gayla post in one of the following ways Share insights on how the anemia you selected I did chronic inflammation anemia is similar to or different from the one your colleague selected.

Discuss how genetic, gender, ethnic, age, and behavioral factors impact the diagnosis and prescription of treatment for anemic patients. and use the readings and resources for at least 2 of the resources or it will not count

Gayla Cragg

Cragg DB 7

COLLAPSE

Pathophysiology of Iron Deficiency Anemia

Iron deficiency anemia occurs as the result of “inadequate dietary intake or chronic blood loss” (Schwartz, McCance, & Rote, 2017, p. 517). These conditions result in depleted “iron stores and reduce hemoglobin synthesis” (Schwartz, McCance, & Rote, 2017, p. 517). Metabolic disorders can “lead to either insufficient iron delivery to bone marrow or impaired iron use (or absorption) within the marrow” (Schwartz, McCance, & Rote, 2017, p. 517). In this case, iron stores are normal, but delivery does not “maintain heme synthesis, thus producing a functional or relative iron deficiency” (Schwartz, McCance, & Rote, 2017, p. 517).

Pathophysiology of Folate Deficiency Anemia

Folate is a vitamin which is required for “RNA and DNA synthesis with the maturing erythrocyte (Schwartz, McCance, & Rote, 2017, p. 516). Schwartz, McCance, and Rote (2017) discussed that “folates are coenzymes required for the synthesis of thyamine and purines” (p. 517). This vitamin is supplied entirely by dietary intake. Absorption can be affected by disorders of the small intestine. After folate is absorbed in the small intestine, it is carried to the liver in the bloodstream, where it is stored (Schwartz, McCance, & Rote, 2017).

Comparison and Potential Causes

Both iron deficiency anemia and folate deficiency anemia can be affected by inadequate dietary intake (Schwartz, McCance, & Rote, 2017). However, iron deficiency anemia is also caused by blood loss. Metabolic changes can affect the delivery of iron stores to the bone marrow in iron deficiency anemia (Schwartz, McCance, & Rote, 2017). Whereas, small bowel disease can affect folate absorption (Schwartz, McCance, & Rote, 2017).

Potential Causes of Iron Deficiency Anemia

Schwartz, McCance, and Rote (2017) noted that “in developed countries, pregnancy and a continuous loss of blood are the most common causes of iron deficiency anemia” (p. 517). Menstrual bleeding is a common cause in females (Schwartz, McCance, & Rote, 2017). In males, potential causes can include hemorrhoids, ulcers, and cirrhosis (Schwartz, McCance, & Rote, 2017). Schwartz, McCance, and Rote (2017) discussed that in developing countries, parasite infections could cause both loss of blood and iron, as well as poor intake a risk factor for children. Lead poisoning and treatment for high lead levels can cause iron deficiency anemia (Schwartz, McCance, & Rote, 2017)

Potential Causes of Folate Deficiency Anemia

Medications such as Dilantin and Phenobarbital can cause folic acid deficiency (Barranger, 2017). Deficiency can also occur when the body’s demand is more than intake as in pregnancy, skin disorders, or chronic hemolytic anemia (Barranger, 2017). Individuals with malabsorption disorders, such as Crohn and celiac disease also may have folate deficiency (Barranger, 2017; Schwartz, McCance, & Rote, 2017). Individuals who suffer from alcoholism are at risk for both folate and thiamine deficiencies, due to the chronic effects of alcohol on the liver and kidneys (Schwartz, McCance, & Rote, 2017)

Effects of Genetics, Gender, Ethnicity, Age, and Behavior

Effects of Age

Lindblad, Cotton, & Allan (2015) noted that iron deficiency anemia is common in the elderly. In patients over age 85, iron deficiency carries increased risk of mortality (Lindblad, Cotton, & Allan, 2015). Evaluation of possible causes such as gastrointestinal disease or cancer is recommended (Lindblad, Cotton, & Allan, 2015). Abrahamsen et al. (2016) noted that in mild and unexplained anemia, close clinical monitoring is recommended.

Effects of Genetics and Ethnicity

Gichohi-Wainaina et al. (2015) discussed “Transmembrane protease, serine 6 (TMPRSS6), is likely to be involved in iron metabolism through its pleiotropic effect on hepcidin concentrations” (p. 441). Gichohi-Wainaina et al. (201) also noted correlations between TMPRSS6 single nucleotide polymorphisms and anemia in Caucasian and Asian populations. Camaschella (2017) noted that iron refractory deficiency anemia is an “autosomal recessive disease, due to mutations of TMPRSS6 gene” (p. 228). Genetic susceptibility to development of iron deficiency after blood donation has been noted for “female carriers of the 736A allele of rs855791 in TMPRSS6, which is associated with low hepcidin levels” (Camaschella, 2017, p. 228).

Effects of Gender

Female gender places individuals at a higher risk of developing iron deficiency anemia related to blood loss with menstruation (Schwartz, McCance, & Rote, 2017). Pregnancy also places increased demands for folic acid and iron stores (Schwartz, McCance, & Rote, 2017).

Effects of Behavior

Poor dietary intake can place individuals at risk of both iron deficiency and folate deficiency anemias (Barranger, 2017; Schwartz, McCance, & Rote, 2017). Alcoholism can affect both males and females, and places individuals at higher risk for folate and thiamine deficiencies (Schwartz, McCance, & Rote, 2017).

References

Abrahamsen, J. F., Monsen, A. B., Landi, F., Haugland, C., Nilsen, R. M., & Ranhoff, A. H. (2016). Readmission and mortality one year after acute hospitalization in older patients with explained and unexplained anemia – a prospective observational cohort study. BMC Geriatrics, 16. doi:10.1186/s12877-016-0284-4

Barranger, K. (2017). Anemias. In Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed., pp. 891-906). Philadelphia, PA: Lippincott Williams & Wilkins.

Camaschella, C. (2017). New insights into iron deficiency and iron deficiency anemia. Blood Reviews, 31(4), 225-233.

Gichohi-Wainaina, W. N., Towers, G. W., Swinkels, D. W., Zimmermann, M. B., Feskens, E. J., & Melse-Boonstra, A. (2015). Inter-ethnic differences in genetic variants within the transmembrane protease, serine 6 (TMPRSS6) gene associated with iron status indicators: a systematic review with meta-analyses. Genes & Nutrition, (1), 1. doi:10.1007/s12263-014-0442-2

Lindblad, A. J., Cotton, C., & Allan, G. M. (2015). Iron deficiency anemia in the elderly. Canadian Family Physician, 61(2), 159.

Schwartz, A., McCance, K.L., & Rote, N.S. (2017). Alterations of hematologic function. In Huether, S. E., & McCance, K. L. Understanding pathophysiology (6th ed., pp. 513-553). St. Louis, MO: Mosby.

Use these readings and resources

Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

Chapter 20, “Structure and Function of the Hematologic System”

This chapter examines components of the hematologic system, development of blood cells, mechanisms of hemostasis, and hematologic value changes in pediatrics and geriatrics. It also focuses on common blood tests for hematologic disorders.

Chapter 21, “Alterations of Hematologic Function”

This chapter focuses on common alterations of hematologic function, including alterations of erythrocyte function, leukocyte function, lymphoid function, splenic function, platelets, and coagulation.

Chapter 22, “Alterations of Hematologic Function in Children”

This chapter expands on alterations of hematologic function by presenting disorders that affect children, such as disorders of erythrocytes, coagulation, and platelets.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 6, “Blood Disorders”

This chapter begins by exploring the anatomy and physiology of blood and the coagulation system. It then examines two types of anemia caused by red cell disorders. White blood cell disorders and platelet disorders are also examined.

Optional Resources

American Sickle Cell Anemia Association. (2010). Retrieved from http://www.ascaa.org/