When assessing for fatigue, inquire about an abnormal craving for ice, which may be a sign of iron-deficiency anemia. Patients on blood thinners may experience a similar craving. — Terri Griffis, RN, FNP-S, Southlake, Tex. (178-7)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.