Folate Deficiency Anemia

1. Treatments and Management

1.1. Oral dose of folate is administered daily until normal blood levels are obtained. Folic acid supplements, vitamin supplements and blood transfusion in severe cases. Eliminating contributing factors, well-balanced diet and frequent rest periods are needed.

2. Nursing considerations

2.1. Vital signs, fluid and electrolyte balance, dietary intake, activity level and oral mucous membranes status. Patient teaching such as importance of well-balanced diet high in folic acid and oral hygiene.

2.1.1. Top Priorities

2.1.2. Medium Priorities

2.1.3. Low Priorities

3. Clinical Manifestations

3.1. Folate deficiency is most prevalent in pregnant and lactating women, elderly, individuals who abuse alcohol and people with intestinal diseases. Severe cheilosis that is scales and fissures of the lips and corners of the mouth. Stomatitis: mouth inflammation or painful ulceration of the buccal mucosa and tongue. Dysphagia or difficulty swallowing, flatulence and watery diarrhea.

4. Risk Factors

4.1. Folate deficiency is a risk factor for development of atherosclerosis and increases the risk for development of coronary artery disease. It is also a risk factor in the development of cancers such as colorectal.

5. Pathophysiology

5.1. Folate is an essential vitamin for RNA and DNA synthesis. Folate are the coenzymes required for the synthesis of thymine and purine and conversion of homocysteine to methionine. Deficient production of thymine affects cells undergoing rapid division or bone marrow cells undergoing erythropoiesis. Absorption of folate occurs in the upper small intestine. Humans are totally dependent on dietary intake of folate.

5.2. When folic acid stores in the body are low or diet is deficient in folic acid, the bone marrow produces large red blood cells or megaloblasts resulting in anemia. It is a common, slowly progressive megaloblastic anemia caused by a deficiency of the vitamin folate.

6. Causative factors

6.1. Folate anemia is common in alcoholics and individuals with chronic malnourishment as ETOH interferes with folate metabolism in the liver. Other causes include dialysis, poor nutrition, substance abuse, bariatric surgeries, bacteria competing for available folic acid and limited storage capacity in infants.

6.2. Inadequate ingestion Inadequate absorption Metabolic block Increased requirement

7. Diagnostic test

7.1. Folate deficiency is most prevalent in pregnant and lactating women, elderly, individuals who abuse alcohol and people with intestinal diseases. Severe cheilosis that is scales and fissures of the lips and corners of the mouth. Stomatitis: mouth inflammation or painful ulceration of the buccal mucosa and tongue. Dysphagia or difficulty swallowing, flatulence and watery diarrhea.