A skill that is relevant to practice in nursing is the approach that health care professionals must follow when treating anemia. In particular, evidence-based guidelines could be used for the treatment of this disorder. Anemia is a disorder that is related to a deficiency in iron, or the ability of the red blood cells to carry oxygen due to an additional cause, often related to the structure of the red blood cells. Since anemia is a broad disorder in terms of its causes and symptoms, it is necessary for the nurse to be aware of the concepts that could be applied when working with patients.
When treating patients for iron-deficiency anemia, it is necessary to consider whether the patient is experiencing any comorbidities. In particular, it is thought that when patients use proton pump inhibitors for gastrointestinal disorder as well as oral iron for iron deficiency anemia, they are not able to absorb the iron to the same extent. This could result in the need for a higher dose of iron supplements if it is not reasonable to withdraw the patient from the use of proton pump inhibitors if they are needed to control gastrointestinal symptoms (Nguyen, Cina & Henriques, 2017).
Research also suggests several additional techniques that could be used to increase the absorption of iron under these conditions (Nguyen, Cina & Henriques, 2017). In particular, it is thought that vitamin C supplements should be taken as well. Some health care professionals recommend that the patient drinks their iron pill with orange juice as well. It is also possible to prescribe additional forms of iron that is unlikely to interact with the altered environment that is caused by proton pump inhibitors. This problem is present primarily because proton pump inhibitors aim to reduce the acidity of the environment, while iron needs an acidic environment to be absorbed properly. It is important for nurses to consider whether this drug interaction might be occurring for their patients, and whether it is reasonable to apply these discussed strategies as a result.
In order to implement this information effectively into practice, it would be beneficial for nurses to carefully review the patient’s charts. If they are known to have iron deficiency anemia, and they are being treated with proton pump inhibitors, it is worthwhile to check this before the administration of either medication (Nguyen, Cina & Henriques, 2017). This is considered to be a common interaction error, so it is beneficial for this to be performed as a check when patients are taking either medication. If a nurse notices this and is not a prescriber, such as a nurse practitioner, it is important to bring this matter to the attention of the physician so that alternative options could be discussed.
It is also necessary for professional nurses to be able to use the evidence to determine how they should approach the treatment of patients with iron-deficiency anemia who are pregnant. Iron deficiency becomes more common during pregnancies, and anemia is a common complication (Amstad Bencaiova, Krafft, Zimmermann & Burkhardt, 2017). When this happens, the child’s health as well as the mother’s health is at risk, so it is important to take action. The impacts that this condition could have on the infant includes a premature birth, stillbirth, increased risk of infection, growth restriction, and others.
As a result of this commonality, it is beneficial to screen all pregnant patients to determine whether they have developed lower than normal levels of iron (Amstad Bencaiova et al., 2014). In addition to the aforementioned options for patients with this disease in general, it is important for the nurse to help the individual understand how to increase the iron that is in her diet. Some patients report sensitivities when taking iron supplements orally, so this would be a beneficial way of addressing the symptoms without negatively impacting the comfort of the patient. Helping patients plan meals that includes iron in it, for example, could help them improve their health status.
Ultimately, it is important for nurses to participate in evidence-based practice because this could lead to a better quality of care as well as improved safety outcomes for their patients. One way to accomplish this when treating patients with iron deficiency anemia is to determine whether the patient is taking any medications that might interact with oral iron. In this instance, it was determined that proton pump inhibitors to treat gastrointestinal disease is a common interactor and methods should be used to increase the acidity of the body’s environment for the iron to work. In addition, pregnant mothers are likely to have temporary iron deficiency anemia, so it is beneficial for the nurse to help them understand which foods have iron and how they could eat more of this in their diet to better manage their anemia. It is important for nurses to recognize these practice issues, so they are able to support the achievement of better outcomes for their patients.
Amstad Bencaiova, G., Krafft, A., Zimmermann, R., & Burkhardt, T. (2017). Treatment of Anemia of Chronic Disease with True Iron Deficiency in Pregnancy. Journal Of Pregnancy, 2017, 1-7. doi: 10.1155/2017/4265091
Nguyen, T., Cina, A., & Henriques, S. (2017). The Effects of Concomitant Use of Proton Pump Inhibitors on Iron Supplements. The Journal For Nurse Practitioners, 13(2), e95-e97. doi: 10.1016/j.nurpra.2016.07.010