A nurse in a provider's office is caring for a client. Exhibits For each client's 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.

Fatigue: Fatigue is a universal symptom in all three conditions due to reduced oxygen-carrying capacity of the blood. This results from low hemoglobin levels or dysfunctional red blood cells, leading to tissue hypoxia and generalized weakness. Ferritin level: Ferritin reflects stored iron. A low ferritin level is a hallmark of iron deficiency anemia, indicating depleted iron stores. Sickle cell disease and pernicious anemia do not typically cause low ferritin unless there is coexisting iron deficiency from blood loss or poor intake. Vitamin B12 level: A low vitamin B12 level directly supports a diagnosis of pernicious anemia, which results from impaired B12 absorption due to lack of intrinsic factor. This finding is not characteristic of iron deficiency anemia or sickle cell disease. Orthostatic hypotension: This may occur in all three conditions due to decreased blood volume or impaired oxygenation. In iron deficiency and pernicious anemia, low hemoglobin reduces circulating oxygen, while in sickle cell disease, dehydration and anemia can contribute to drops in blood pressure when changing positions.