Iron and Transferrin (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Now, do you think iron can be made by the body? Can my body make its own iron? Nope, it cannot.

    00:12 Iron is not made in the body, and it has to be absorbed from what we eat.

    00:16 So iron is a mineral, and the body needs it for growth and development.

    00:21 So iron deficiency is not a good deal.

    00:24 Now we've got different foods up there to remind you, these are the types of foods that are rich in iron, and this is the only way we get it.

    00:32 So see why it's so important that we make healthier choices about diet, because it plays a huge impact on growth and development.

    00:41 Now adults know those choices are one thing, but what about children? Pediatrics, we know, wow, they are definitely growing and developing.

    00:50 So iron is going to be really important.

    00:52 Think about our geriatric population, they may not be as interested in food as they used to be.

    00:58 So it's important that the food they are eating has the type of nutrients and minerals their body needs to stay healthy.

    01:07 So we know that I can't make iron by myself, I've got to ingest it, right.

    01:13 So iron is an essential element for blood production.

    01:17 Hello, that's something worth noting.

    01:20 So about 70% of the body's iron is found in the red blood cell.

    01:25 So if I don't have enough iron ingested, I'm not going to have enough red blood cells.

    01:31 That's a problem because red blood cells have the hemoglobin, and that's what carries oxygen to my tissues.

    01:39 So hemoglobin in my blood cells carries oxygen.

    01:42 In muscle cells, we have myoglobin.

    01:46 Look at this cool animation, let's look at the differences between hemoglobin and myoglobin.

    01:53 Now we know that our body uses iron for blood production and to make hemoglobin.

    01:57 So let's look at that one first.

    01:59 We already talked about what the job is of hemoglobin.

    02:03 It carries oxygen from the lungs to all parts of the body.

    02:07 So red blood cells, that's their job to make sure that they carry oxygen from the lungs to the rest of the body.

    02:16 Now, myoglobin is a protein in muscle cells and it accepts and stores and transports and releases.

    02:22 Wow, that's a lot.

    02:24 So it's a protein, it's in my muscle cells.

    02:28 And look at all the things it does with oxygen.

    02:30 It accepts it, it can store it, it transports it and it releases oxygen.

    02:37 Okay, and those proteins are located in your muscle.

    02:41 Now an easy way to remember that my- usually indicates muscle.

    02:45 So hemoglobin is in my blood, myoglobin is in my muscle.

    02:51 And both of these involve oxygen.

    02:54 So when you're comparing, doing compare and contrast between two things, quick way to do that is to make yourself a chart.

    03:00 Then ask yourself questions, quiz yourself, which one is in the muscles? Myoglobin.

    03:04 Which one is in red blood cells? Hemoglobin.

    03:07 Which one and just go on and on, asking yourselves questions over and over again.

    03:12 It's also a great way to get your family involved, write out practice questions, have them quiz you.

    03:17 Because asking questions is such a better use of your time and your mental energy than reading and rereading and reading and reading, or highlighting.

    03:27 Or some of us call it coloring because we just highlight everything.

    03:31 So we always try to give you study tips as we go along the way.

    03:35 And I promise you, that is a really important one.

    03:40 Now iron in the body, we talked about ferritin.

    03:43 Ferritin stores iron, and then transferrin is important.

    03:48 Okay, that's pretty cool.

    03:50 So ferritin stores iron, transferrin transports it, which is why we put it on a truck to help you see, look, it's loaded up with little ferritins, right? So that's where the iron is stored, and transferrin is what transports iron in the body.

    04:08 So we want to take a look at what transferrin represents in your body.

    04:11 Can you remember what the job of transferrin is? Transferrin transports iron in the body.

    04:20 Okay, that's super cool.

    04:22 So we've got that fairly easy to remember.

    04:25 So transferrin is the iron transport protein.

    04:29 Now we gave you kind of an idea of what it really would look like under a microscope.

    04:33 You notice it's not a truck, right? But we wanted you to have that image to help you remember transferrin - transportation, transferrin transfers iron.

    04:44 So why am I repeating that? Not because I don't think you're bright because I think the opposite.

    04:51 I know you are sharp because you're doing the work of studying right now.

    04:57 But you use repetition to help things begin to stick in your brain.

    05:01 Memorization is a part of learning, but it is just the first baby step.

    05:07 So let's move past that.

    05:09 transferrin is the iron transport protein in serum, it combines with ferritin to transport iron to where new red blood cells are made.

    05:19 Okay, that's super cool.

    05:21 So I know that transferrin is the protein that transports right? It's in the serum, because it combines with ferritin and so it can take the iron to where new red blood cells are made.

    05:33 And that's a really good thing, because red blood cells are what carry oxygen around to perfuse my entire body.

    05:42 So why would a health care provider look at a transferrin level? I mean, what could you learn from that? Well, if a client has a high level, they may have iron deficiency anemia.

    05:53 Okay, so a high level would indicate this system isn't working.

    05:58 Iron deficiency anemia means low red cell count, that's what anemia means, and the cause is iron deficiency.

    06:07 That system is not functioning in their body.

    06:10 If they have a lower level of transferrin, there could be some other problem like liver disease and hemolytic anemia, those red cells are just getting destroyed.

    06:18 So you're going to look at the underlying cause of the transferrin.

    06:25 And again, we've got a normal range for you there.

    06:27 That's just an example of a normal range.

    06:30 We've listed there, always check your hospital or lab protocol and policy for the normal ranges where you are practicing.

    06:38 Let's apply what we've learned about transferrin to what a transferrin saturation can tell us because it's actually pretty cool.

    06:47 We know that transferrin's job is to transport iron.

    06:51 So the place where we make red blood cells.

    06:54 So why do we care about saturation? Well, look at what saturation can tell us.

    07:00 It will actually tell us how many places on your transferrin that can hold iron that are actually doing it.

    07:07 Now let me say that one more time.

    07:09 Saturation tells us how many places on your transferrin that can hold iron are actually doing so.

    07:16 So if you think about it, what that means, transferrin transports iron, right? And my saturation, if it's low then, 'Oh, that means I don't have enough iron to transport'.

    07:29 So that would tell me that you likely have something like an iron deficiency anemia.

    07:34 Well, anemia means low red blood cell count.

    07:38 And when it's iron deficiency anemia, that means it's caused by not enough iron in your body.

    07:44 Now why you don't have the iron? We won't know without more questions.

    07:48 We have to look at the liver function, we have to look at their diet, those are the kinds of things we'd need to take a look at.

    07:54 But what if the saturation is higher, what do you think? Yeah, it could be iron overload.

    08:00 Now, you won't see this very often, but if you do, you really want to dig down even deeper into the supplements that your patient is taking, or even the specific iron supplements in a multivitamin.

    08:13 So it could be any one of those things that they're ingesting, but the idea, you're catching on, you're always going to need to ask more questions to identify what's the true source of an abnormal lab work.

    08:26 So keeping in mind transferrin saturation, that's telling me what the available units are able to carry.

    08:33 If it's low, I probably have iron deficiency anemia.

    08:37 If it's high, I have iron overload.

    08:40 So here's the normal range, make sure you check it with where you're practicing and with your policy to make sure you know what the normal range is in your setting.

    08:49 Remember, severe cases of iron deficiency anemia, this number could be really low.

    08:55 In our example, we would say like less than 10%.

    08:58 And if you've got anemia, remember, you're gonna have perfusion problems all over the body.

    09:04 And that's how these GI labs can tell us so much about what's going on in a patient's body.

    About the Lecture

    The lecture Iron and Transferrin (Nursing) by Rhonda Lawes, PhD, RN is from the course Assessment of the Geriatric Patient: Gastrointestinal System (Nursing).

    Included Quiz Questions

    1. It is used to make hemoglobin in the body.
    2. It is manufactured in the body by red blood cells.
    3. It is only found in red meat.
    4. It is not essential to human development.
    1. Red blood cells
    2. Bone marrow
    3. Thymus
    4. Heart
    1. Myoglobin
    2. Hemoglobin
    3. Transferrin
    4. Albumin
    1. Transferrin
    2. Albumin
    3. Myoglobin
    4. Hemoglobin

    Author of lecture Iron and Transferrin (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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