A nurse in a provider's office is caring for a client. Exhibits For each client finding, click to specify if the assessment finding is consistent with sickle cell disease, iron deficiency anemia, and/or pernicious anemia. Each finding may support more than 1 disease process.

Ferritin level (15 ng/mL) IDA: Ferritin is the primary iron storage protein, and low levels indicate iron deficiency. SCD: Ferritin can be normal or high due to repeated transfusions; low ferritin is not characteristic. PA: Ferritin is typically normal; B12 deficiency is the key feature. Vitamin B12 level (144 ng/mL) PA: Pernicious anemia results from B12 deficiency due to intrinsic factor deficiency or malabsorption. IDA/SCD: B12 is usually normal. Fatigue All three conditions: Fatigue is a common symptom of anemia, regardless of etiology. Orthostatic hypotension All three conditions: Low hemoglobin or anemia reduces oxygen delivery, potentially causing dizziness or hypotension upon standing.