From the Guidelines
For a 16-year-old female with iron deficiency anemia and a hemoglobin of 7.3 g/dL, the plan of care should include oral iron supplementation with ferrous sulfate 200 mg once daily, providing approximately 65 mg of elemental iron per dose, for 3-6 months, as this regimen has been shown to be effective in normalizing hemoglobin levels with minimal side effects 1.
Key Considerations
- The patient should be advised to take iron with vitamin C (orange juice or a 250 mg vitamin C supplement) to enhance absorption, and on an empty stomach if tolerated, as this can improve the efficacy of iron supplementation 1.
- It is essential to avoid taking iron with calcium, dairy products, tea, coffee, or antacids, which can reduce absorption, and to monitor for common side effects such as constipation, black stools, and gastrointestinal discomfort 1.
- A stool softener like docusate sodium may be added if constipation occurs, and dietary counseling should focus on iron-rich foods such as lean red meat, poultry, fish, beans, and fortified cereals 1.
Laboratory Monitoring
- Laboratory monitoring should include repeat hemoglobin levels after 4 weeks of therapy, with a target hemoglobin increase of 1-2 g/dL per month, to assess the response to treatment and adjust the regimen as needed 1.
- Continue iron therapy for 3 months after hemoglobin normalizes to replenish iron stores, as this can help prevent future episodes of iron deficiency anemia 1.
Further Investigation
- Further investigation into the cause of iron deficiency is essential, particularly evaluating for menstrual blood loss, gastrointestinal bleeding, or dietary insufficiency, to address the underlying cause of the anemia and prevent future episodes 1.
- If oral iron is not tolerated or if there's no improvement after 4 weeks, consider intravenous iron formulations, as this can provide a more rapid and effective increase in hemoglobin levels 1.
From the Research
Plan of Care for 16-Year-Old Female with Iron Deficiency Anemia
- The patient's hemoglobin level is 7.3, indicating severe iron deficiency anemia 2, 3.
- The primary goal of treatment is to increase hemoglobin levels and improve iron stores.
- Oral iron therapy is the first-line treatment for iron deficiency anemia, with a recommended dosage of 3 to 6 mg/kg of elemental iron per day 3, 4.
- Ferrous sulfate is a commonly prescribed oral iron supplement, and studies have shown it to be effective in increasing hemoglobin levels in patients with iron deficiency anemia 5, 4.
- The patient's response to oral iron therapy should be monitored, and if there is no significant increase in hemoglobin levels after 14 days, alternative treatments such as intravenous iron may be considered 5.
- In addition to iron supplementation, dietary counseling and nutritional education are important for preventing and treating iron deficiency anemia 3.
- The patient's quality of life and fatigue levels should also be monitored, as iron deficiency anemia can have a significant impact on these aspects of health 5, 6.
Treatment Options
- Oral iron therapy: ferrous sulfate or iron polysaccharide complex 3, 4
- Intravenous iron therapy: for patients who are intolerant to oral iron or have severe iron deficiency anemia 5, 6
- Dietary counseling and nutritional education: to promote iron-rich foods and prevent iron deficiency anemia 3