What finding may indicate severe iron-deficiency anemia?

The finding that may indicate severe iron-deficiency anemia is pale, cool skin. This occurs because iron is crucial for the production of hemoglobin, which is responsible for transporting oxygen in the blood. When a person has severe iron-deficiency anemia, there is insufficient hemoglobin to adequately supply oxygen to the tissues, leading to a decrease in blood flow to the skin and overall pallor. The skin may also feel cool to the touch due to reduced perfusion.

In contrast, warm, flushed skin is typically associated with conditions that increase blood flow or are indicative of fever, neither of which align with the clinical presentation of severe iron-deficiency anemia. A bounding pulse might occur in conditions of high cardiac output or emotional states and does not specifically relate to iron deficiency. A normal respiratory rate does not reflect the underlying complications of severe anemia, where tachypnea may occur as the body attempts to compensate for decreased oxygen carrying capacity. Therefore, the presence of pale, cool skin serves as a hallmark clinical sign of severe iron-deficiency anemia, highlighting the systemic effects of decreased red blood cell and hemoglobin levels.