NUR 426 Lecture Notes - Lecture 14: Iron-Deficiency Anemia, Chromium Deficiency, Peptic Ulcer
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Vitamins and Minerals
Iron
• Supplements – to treat iron deficiency anemia; used as supplement during pregnancy
- 10-20% absorption from stomach (weather from foods or supplements); sored in small
intestines and liver a ferritin
- Essential for normal production of Hg and RBCs; it is recycled and reused
- Deficiencies may be due to GI bleeding or heavy menstruation
• How is the medication administered?
- Oral: ferrous sulfate; often given with Vitamin C to enhance absorption
- Liquid: available in multiple concentrations – CAUTION needed to prevent overdose; use
straw or dilute and rinse mouth (teeth staining)
- IM: Z-track method to prevent tissue irritation and staining; BLACK BOX warning for Irion
Dextran (parenteral form) – risk of anaphlaxysis and death
• Patient education
- Good dietary sources: beef liver, red meat, fish, poultry, clams, tofu, oysters, lentils, dried
peas, beans, fortified cereals, bread and dried fruit
- Take iron with meals and 8oz fluid to avoid stomach upset
- Do not take with coffee or caffeine -> decreases absorption
- Do not crush or chew
- Stools may be dark green or black
- Report constipation to healthcare provider; report change in color or consistency
- Oral preparations differ in dosage – not interchangeable
• Nursing Care
- Assessment
➢ Health history: peptic ulcer, colitis (contraindicated); children in home? (childproof
caps; poison control #)
➢ Labs: Hg, RBC, (MCV, MCH), iron level, ferritin levels
- Medication Administration:
➢ Do not give with antacids, tetracycline or quinolones
➢ Do not crush extended release preparations
- Monitoring
➢ Signs of overdose: nausea, vomiting, diarrhea (green tarry stools), hemorrhage,
pallor, cyanosis, shock, coma
- Teaching
➢ Usual side effect: nausea (usually transient); heartburn, bloating, constipation
➢ Dietary source: liver – lean meats – egg yolk – dried beans – green vegetables – fruit
Copper
• Why is this medication used?
- To treat copper deficiency which may lead to anemia, decreased WBCs, glucose intolerance,
skin/hair pigment, retardation
• How do the medications work?
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