A client diagnosed with anemia who is being treated with irion replacement therapy is not responding to clini?

Question

A client diagnosed with anemia who is being treated with irion replacement therapy is not responding to clinical treatment and reports tingling and paresthesias of the extremities. Which of the following might account for this poor response to therapy?

a. client compliance with iron replacement therapy

b. underlyding medical condition of diabetes that is complicating the course of treatment

c. client may also have a vitamin B-12 deficiency that may account for presentation of neuropathy symptoms

d. client may be taking vitamin C supplements that may account for presentation of neuropathy symptoms

Answer 1

c is the answer. B-12 deficiency leads to Beriberi, which has symptoms like it describes. Diabetes causes a LOSS of sensation in those severe cases that lead to neuropathy. Vitamin C isn't going to affect iron therapy, nor can it cause the symptoms described. Answer 'a' is obviously wrong.

Answer 2

The anemia could be do to something other than iron deficiency - there are many causes of anemia.
Before starting a treatment for anemia, it's important to find out what's causing it. Iron deficiency, for example, if it is that, is not even enough of an answer. You have to find out WHY the person is iron deficient. Unless it is obvious- major blood loss that is visible, it may be something like a tumor in the colon or an ulcer. Other types of anemia such as that from B12 deficiency, which causes a neurological condition as well called "combined systems disease", will not respond to iron. That type of anemia needs B12 - either shots or large doses by mouth will work in some cases.
In your situation above, the client could have B12 deficiency or could have another problem unrelated to the anemia which is causing the numbness and tingling such as diabetes.
So in your scenario possible answers would be either b or c.
As far as I know Vitamin C does not cause neuropathy.
There are lots of causes of anemia - iron deficiency and B12 deficiency are just two of the many.

Answer 3

A, if iron overload is the real problem. If patient is complying, they shouldn't be!

It is possible to present as anemic (hemoglobin) and still have high storage iron. The proper tests (ferrin, transferrin saturation etc.) must be done to determine this.

There is a connection between even a very slightly elevated storage iron (the reference ranges are considered too high by some) and increased risk of diabetes II (and the Metabolic Syndrome). Diabetes, then in turn, can affect iron metabolism.

If a client comes up as anemic (especially men and post-menopausal women), one has to find the reason for the anemia first. Not give iron. Giving iron to an iron overloaded patient would be contributing to their death.

If the patient is iron overloaded and they are taking vitamin C supplements, then they are increasing their absorption of iron from their food, further adding to their already-elevated iron load.

Answer 4

The answer could be b or c. You did not specify which type of anemia this client had. The reason he/she is not reponding to treatment may be that the treatment is inappropriate (ex. he has megaloblastic anemia and you are giving iron replacement therapy) or he/she has anemia of chronic disease which responds poorly to treatment. a is also a possibility but would not explain the paresthesias. I don't believe there are any neuropathic symptoms associated with Vitamin C supplements.

Answer 5

If your client is not responding then perhaps something else is causing the iron loss. Ever heard of things like Hemocromitosis? Docs just don't look further than their nose anymore .. keep looking somethings wrong probably not the client probably the non scientific doctor who's treating her . Get your microscope out and look please. Stop blaming the patents for things Or perhaps refer her to a blood doctor duh! that's what they do they know about blood problems

Answer 6

It wont affect your baby as much as it affects you. Your body is bult to give your baby all the nuterients it needs. So all the iron in your body will end up going to your baby which will make you more and more anemic as you go through your pregnancy. If you are severly anemic when you deliver you run the risk of need a blood transfusion.

Answer 7

c