RN Nursing · Iron-Deficiency and Nutritional Anemias · Practice question
A patient with iron deficiency anemia (Hgb 7.8 g/dL) reports chest pain and tachycardia. What is the priority nursing action?
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✓
Assess oxygenation and apply oxygen
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Administer oral iron
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Provide dietary teaching
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Encourage ambulation
Answer & explanation
Correct: Assess oxygenation and apply oxygen
When a patient with iron deficiency anemia reports chest pain and tachycardia, these symptoms signal that the body's compensatory mechanisms are failing to maintain adequate oxygen delivery to tissues. With a hemoglobin of 7.8 g/dL, the oxygen-carrying capacity of the blood is significantly reduced, and chest pain with tachycardia indicates cardiac stress from hypoxia. The priority action is to assess oxygenation and apply supplemental oxygen, because correcting tissue hypoxia takes immediate precedence over any other intervention. Oxygen administration addresses the life-threatening physiological compromise directly. Administering oral iron addresses the underlying deficiency but acts over weeks and provides no immediate benefit during an acute symptomatic episode. Providing dietary teaching is entirely inappropriate during an acute cardiovascular event — education is a long-term strategy and does not address the emergent situation. Encouraging ambulation is contraindicated because it would increase oxygen demand in a patient who is already experiencing cardiac stress from insufficient oxygen delivery. The nurse must first stabilize the patient's oxygenation, document findings, and notify the provider, as the patient may require a blood transfusion or urgent evaluation for acute coronary syndrome secondary to anemia-induced ischemia.
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