Assignment Task:
Biochemical profile, platelets, white cell count, B12, folate and CRP are normal. Robert's low haemoglobin, ferritin, MCV and MCH confirm iron deficiency anaemia. Further discussion with Robert reveals he was investigated for iron deficiency anaemia 6 months ago when his haemoglobin was 112 g/L. His gastroenterologist was contacted who confirmed that he had no overt bleeding and that his endoscopy and colonoscopy showed no abnormalities. His anaemia was attributed to his recent surgery. Robert was prescribed oral iron tablets which he only took for a few weeks due to nausea and constipation. He was planning to go back to his general practitioner but work commitments prevented this. The gastroenterologist agrees to review Robert after discharge, to investigate other possible causes of anaemia, as his haemoglobin has dropped significantly since his last consultation. Management option What initial anaemia management would you recommend and discuss with Robert? Refer to a dietitian immediately so he can increase his iron intake Give two units of red cells to increase his haemoglobin level Commence oral iron tablets immediately and continue these for a period of three months Transfuse one unit of red cells and reassess his signs and symptoms post transfusion