A 4-year-old African American is brought to the clinic for frequent nosebleeds and has pale mucous membranes. He is diagnosed to have iron deficiency anemia. He is scheduled to start iron therapy. The mother asks the nurse about the likely cause of her son's illness. Which of the following is the correct response of the nurse?

Chronic blood loss


•Chronic blood loss is associated with iron deficiency anemia. In this scenario, his chronic nosebleeds are the most likely cause.

•Children are at a high risk for iron deficiency anemia because they need a lot of daily dietary iron intake in proportion to their body weight than adults.

 Iron deficiency anemia is a microcytic anemia often caused by chronic blood loss from minor gastrointestinal bleeding or colon cancer. Over time, the demands for iron exceed intake. Even blood loss of 10-20 milliliters of red cells per day is more iron a person can absorb in the diet. Manifestations of iron deficiency anemia include fatigue, pallor, fissures at the corners of the mouth, spooning of fingernails, and reduced exercise tolerance. Anemia is defined as HGB < 13 g/dL for men and <12 g/dL for women.

Incorrect options:

•Inadequate intake and GI disease are also possible causes of iron deficiency anemia; however, this patient has chronic blood loss, so the nurse should suspect this cause.

•Low birth weight is a cause of anemia in infants, but this generally only affects infants for the first three to six months of life.

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