Conditions › Blood & cancer
Iron Deficiency Anemia Nursing Care Plan and Interventions
Iron deficiency anemia nursing care looks for the source of blood loss, paces activity and teaches how to take oral iron: on an empty stomach if tolerated, with vitamin C, away from antacids and dairy. Dark stools and constipation are expected with iron.
Iron deficiency anemia nursing care plan
| Nursing problem | Goal | Key interventions |
|---|---|---|
| Activity intolerance (fatigue) | Completes activities with rest breaks. | |
| Risk for injury (falls from dizziness) | No falls. | |
| Health maintenance: needs teaching | Takes iron correctly and eats iron-rich foods. |
Problem wording is plain-language nursing diagnosis style. Your program may require NANDA-I labels and your own assessment data.
What it is
Iron deficiency anemia: what it is
Too little iron to build hemoglobin, so red cells come out small and pale and carry less oxygen. 1,2
Small and pale: microcytic (MCV under 80 fL) and hypochromic.
Main cause: blood loss
Chronic blood loss (heavy periods, slow GI bleeding) leads. Also low intake and poor absorption (celiac disease, gastric surgery). 3,2
In a man or a postmenopausal woman, suspect a hidden GI bleed until proven otherwise.
Assessment: what you will see
Anemia cues you will see
Fatigue, weakness, pallor and shortness of breath. When severe: tachycardia, low BP and low SpO2. 2
The heart speeds up to move the oxygen the blood can no longer carry.
Iron clues: pica and spoon nails
Severe deficiency: craving ice, dirt or starch (pica), spoon-shaped nails, a sore smooth tongue, cracked mouth corners. 3
A client who chews ice all day: ask about iron.
Key labs in iron deficiency
Low serum iron, high iron-binding capacity and low ferritin, with small cells on the CBC. Ferritin is the stored iron. 3
Ferritin is stored iron. Stores empty first, so ferritin falls before the hemoglobin does.
Priority: what the nurse does first
Priority nursing care
Fall precautions, rest between activities, trend Hgb, check stools for blood. Oxygen and transfusion as prescribed if severe. 2
Dizzy on standing? Sit the client down and keep them safe first, then check vitals.
Nursing interventions and treatment
Oral iron: how to take it
Absorbs best on an empty stomach, about 30 minutes before meals, with vitamin C or orange juice. Dairy, calcium and antacids cut absorption. 3
Take it with orange juice, not milk, and keep calcium and antacids for another time.
IV iron
Gives a faster response than oral iron, but allergic or infusion reactions can occur. Used when pills fail or aren't tolerated. 3,4
Watch for hypersensitivity during the infusion and for at least 30 minutes after.
Evaluation: is care working?
Is it working?
Reticulocytes rise in about 1 week; Hgb climbs in 1 to 2 weeks and should be corrected within 2 months. 3
Keep taking iron about 6 months after Hgb is normal to refill stores. No rise: look for ongoing bleeding.
Client teaching
Oral iron: expected effects
Dark or black stools are expected. Constipation, nausea and stomach upset are common. 5,2
Warn the client about dark stools ahead of time, and push fluids and fiber for constipation.
Iron safety at home
Iron overdose is a leading cause of fatal poisoning in children under 6. Store it out of reach with child-resistant caps. 4
Vitamins with iron count too. Close the child-resistant cap fully every time.
Iron-rich foods
Red meat, poultry and fish absorb best. Beans, lentils, dark leafy greens and iron-fortified cereal also count. 2,1
Pair plant iron with a vitamin C food to boost absorption.
NCLEX traps
Iron deficiency vs pernicious anemia
Iron deficiency: small red cells (microcytic). Pernicious anemia: large red cells (macrocytic) plus numbness and tingling. 6,2
Both bring fatigue and pallor. Cell size and nerve signs tell them apart.
Keep studying iron deficiency anemia in NurseLingo Pro
Everything for iron deficiency anemia in one place. A free account gets 5 free opens of any condition; Pro opens all 277.
Test yourself: free med-surg practice questions with answers and rationales.
Frequently asked questions
What are the priority nursing diagnoses for iron deficiency anemia?
Common nursing problems for iron deficiency anemia include activity intolerance (fatigue); risk for injury (falls from dizziness); health maintenance: needs teaching. Choose the ones your assessment supports and rank airway, breathing and circulation problems first.
What does the nurse do first for iron deficiency anemia?
Fall precautions, rest between activities, trend Hgb, check stools for blood. Oxygen and transfusion as prescribed if severe.
What are the nursing interventions for iron deficiency anemia?
Look for the cause of blood loss, pace activities with rest to manage fatigue, prevent falls from dizziness and teach how to take oral iron: before meals with vitamin C, away from dairy and antacids. Dark stools and constipation are expected side effects.
Related cheat sheets
Sources
- OpenStax Nutrition for Nurses, 9.1
- OpenStax Medical-Surgical Nursing, 16.1
- merckmanuals.com
- dailymed.nlm.nih.gov
- OpenStax Fundamentals of Nursing, 27.2
- OpenStax Nutrition for Nurses, 10.1
For study only, not medical advice. Follow your program, your facility's policies and the provider's orders.