Pegasus skilled caregivers in Newhall and our other locations provide all levels of assistance to a variety of individuals. They care for patients of every age; however, most are seniors. Managing hemochromatosis is one of the challenges you’ll experience in your career as a home health care nurse.
Iron, a mineral, is an essential nutrient that bodies require to function correctly. People consume the amounts needed in their food. Their body has no natural way to eliminate excess iron and stores it.
Excess Iron Accumulation Leads To Iron Overload
Hemochromatosis, also known as iron overload, is a condition in which an individual’s body stores too much iron. The accumulation of iron often damages tissues and organs. Hemochromatosis may be either inherited (primary) or due to secondary causes (acquired).
Hereditary hemochromatosis is the most common type and one of the most common genetic disorders in the U.S. Statistically, your patient is more likely to be white. The condition is “less common among African Americans, Asian Americans, Hispanics/Latinos, and American Indians.”
If a male, he may have had it from a young age. If a female, she is most likely past menopause. Your male patient is at higher risk for complications than your female patient.
Primary hemochromatosis results from a gene mutation. More than one gene may be affected. There are five types of hereditary hemochromatosis defined by which genes have mutations.
Additionally, neonatal hemochromatosis affects some babies. The organ damage begins before birth and progresses rapidly. Your assistance may be necessary for both mother and newborn once they are home.
Secondary hemochromatosis has a variety of causes. These include:
- Alcoholism or alcoholic liver disease
- Blood transfusions for conditions such as anemia, sickle cell disease, or thalassemia
- Chronic hepatitis B or C
- Overuse of supplements containing iron
- Using iron cookware
Your home healthcare may include assisting with the underlying conditions as well as the hemochromatosis itself.
Symptoms Of Iron Overload
Whether due to primary or secondary causes, an individual’s body stores the excess iron in its organs. The heart, liver, and pancreas are the most affected. Without treatment, individuals may experience symptoms such as:
- Arrhythmia
- Arthritis
- Cirrhosis of the liver
- Diabetes
- Disorders of glands like the adrenals, thyroid, or pituitary
- Enlarged liver
- Heart failure
- Liver cancer
- Liver failure
- Reproductive system disorders
As a home health nurse, you may be managing hemochromatosis symptoms as well as a chronic disease.
Additional symptoms are often mistaken for other conditions. Those symptoms include, but aren’t limited to:
- Abdominal pain
- Fatigue and weakness
- Joint pain
- Memory fog
- Weight loss
Skin color that looks bronze or gray is a telltale symptom of iron overload.
Phlebotomy Reduces Iron Overload
Hemochromatosis is not curable, but it can be treated. Treatment involves lowering the amount of iron in the body. Since iron circulates in the blood, phlebotomy is the usual treatment.
Newly diagnosed patients usually have up to a pint of blood removed once or twice a week. Phlebotomy scheduling is based on factors like age and overall health. The severity of their disease is also a factor.
Once your patient is put on a maintenance schedule, you’ll draw blood less often. The scheduling will depend on the rate that iron accumulates. You’ll need to be aware of their symptoms and arrange for appropriate testing.
If your patient has secondary hemochromatosis, they may not be able to undergo phlebotomy. Their treatment will involve chelation, a process in which medication is administered that binds to iron. The excess iron is eliminated via their urine or feces.
Patient Education Is Part Of Home Healthcare
A crucial part of your care will include education. Your patient may not understand why blood has to be drawn when they feel tired. They also may regard phlebotomy as an ordeal and not want to comply with it.
It’s possible that their busy physician didn’t have time to explain the consequences of declining treatment. Or they were too stressed to comprehend the explanation. You will need to help them, and their family members, understand the diagnosis and treatment.
You will probably need to work with patients on a diet that reduces their intake of iron. Your Pegasus team includes a dietitian, who can assist with specifics and meal planning if needed. In general, your patient should:
- Avoid animal fat and sugar
- Consume alcohol only in moderation
- Drink more coffee and tea
- Increase consumption of whole grains, rice, beans, vegetables, and fruit
- Limit intake of Vitamin C (it increases absorption of iron)
- Reduce consumption of red meat
Caution them against consuming raw seafood in any form. It contains a bacterium that is deadly for individuals with hemochromatosis.
You may also have to teach patients to read the labels of supplements to avoid consuming iron. Any ingredient that contains the word ferrous is a form of iron. Examples to avoid include ferrous sulfate, ferrous gluconate, and ferric citrate, among others.
Pegasus is a licensed Home Care Organization and a Joint Commission Accredited Home Health Care organization. Our skilled caregivers in Newhall and our other locations tailor their assistance to meet each individual’s needs. Your career as a home health care nurse allows you to provide the multi-faceted care needed to manage hemochromatosis.
