Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing which of the following results would indicate this type of anemia?
A. An elevated hemoglobin level.
B. A decreased reticulocyte count.
C. An elevated RBC count.
D. Red blood cells that are microcytic and hypochromic.
Correct Answer: D. Red blood cells that are microcytic and hypochromic.
The results of a CBC in children with iron deficiency anemia will show decreased hemoglobin levels and microcytic and hypochromic red blood cells. The CBC documents the severity of the anemia. In chronic iron deficiency anemia, the cellular indices show a microcytic and hypochromic erythropoiesis—that is, both the mean corpuscular volume (MCV) and the mean corpuscular hemoglobin concentration (MCHC) have values below the normal range for the laboratory performing the test.
Option A: Hemoglobin electrophoresis and measurement of hemoglobin A2 and fetal hemoglobin are useful in establishing either beta-thalassemia or hemoglobin C or D as the etiology of the microcytic anemia.
Option B: The reticulocyte count is usually normal or slightly elevated. Mateos Gonzales et al assessed the diagnostic efficiency of commonly used hematologic and biochemical markers, as well as the reticulocyte hemoglobin content (CHr) in the diagnosis of iron deficiency in children, with or without anemia.
Option C: The red blood cell count is decreased. If the CBC is obtained after blood loss, the cellular indices do not enter the abnormal range until most of the erythrocytes produced before the bleed are destroyed at the end of their normal lifespan (120 d).
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