Contributing Factors Putting the Patient at Risk of Developing Iron Deficiency Anemia

Contributing Factors Putting the Patient at Risk of Developing Iron Deficiency Anemia

The contributing factor putting J.B at risk of developing iron deficiency anemia is blood loss resulting from prolonged menstruation and intermenstrual bleeding. The case study suggests that the patient has gone through two months of menorrhagia and six days of heavy flow and cramping. According to Dlugasch & Story (2019), women of childbearing age lose approximately 1mg of iron through menstruation. Thus, the patient would lose iron when she bled. Predominantly, her chances of developing iron deficiency anemia increased with the heaviness of her periods. Additionally, gastrointestinal bleeding from the peptic ulcer could have put the patient at risk of developing the condition.

The Reasons the Patient Might Present Constipation and Dehydration

I think the patient might present constipation as a side effect of omeprazole intake (Shah & Gossman, 2019). On the other hand, dehydration could result from taking diuretics. According to the case, the patient has a 3-year history of hypertension which she manages using a diuretic and a centrally acting antihypertensive drug. Diuretics are water pills. These medications help a patient’s kidneys to eliminate sodium from the body. As a result, the fluid within a patient’s blood vessels decreases, causing blood pressure reduction. The primary side effect of the diuretic medication is dehydration since while the body gets rid of sodium, the body releases the sodium with water (Arumugham & Shahin, 2021). The centrally acting antihypertensive drug could also contribute to the patient’s constipation since it is a side effect that patients experience when consuming the drugs (Khalil & Zeltser, 2022). Frequent urination without drinking enough water could also be a reason for developing dehydration.

Why Vitamin B12 and Folic Acid are Crucial in the Erythropoiesis

The two components are crucial in the erythropoiesis process to facilitate cellular DNA synthesis. The abnormalities Vitamin B12 and Folic Acid deficiencies can cause on the red blood cells include the inability of the RBC to undergo nuclear division, premature death, and phagocytosis of precursor cells (Dlugasch & Story, 2019).

The Clinical Symptoms Supporting a Positive Iron Deficiency Diagnosis

Weakness-reduced-oxygen carrying capacity
Fatigue-reduced oxygen-carrying capacity
Dyspnea- shortness of breath due to insufficient oxygen supply to vital organs within the body
Signs of Iron Deficiency Anemia

Pallor-reduced hemoglobin in the blood, causing the skin to look pale
Syncope- insufficient blood flow to the brain
Tachycardia- compensation mechanism in which the heart compensates for the lack of red blood cells reaching the body’s tissues by pumping faster
Cyanosis of sclera-Hypoxia. The sign refers to the change in color of the eye sclera from white to blue due to insufficient oxygen supply
Appropriate Recommendations and Treatment for the Patient Based on Lab Results

The patient’s hemoglobin level is below the normal range of above 12 g/dL for females. Also, the hematocrit (Hct) range is lower than the required 37%, which is the normal range (Dlugasch & Story, 2019). The normal range of Ferritin in females is 10 to 120 ng/mL for adults, 18 to 39 years. The patient’s erythrocytes were smaller and paler in color than normal due to reduced hemoglobin and the need to compensate for this reduction (Dlugasch & Story, 2019). Overall, the patient tested positive for anemia.

I recommend the patient start taking folic acid supplements and consuming folate-rich foods. These components will help the patient’s body to make new healthy red blood cells (Kumar et al., 2022).
Also, I recommend that the patient consume food rich in iron or iron supplements to compensate for the iron loss during bleeding (Dlugasch & Story, 2019). These include dark leafy greens (spinach, romaine lettuce, collard greens), asparagus, broccoli, citrus fruits, beans, peas, lentils, avocado, and Brussels sprouts (Kumar et al., 2022).
Alternatively, the patient could receive transfusions of red blood cells.
I would treat the underlying cause of blood loss to reduce the risk of developing iron deficiency anemia
Cardiovascular Case Study

The Modifiable and Non-Modifiable Risk Factors for Patients at Risk of Developing

Coronary Artery Disease and Those Diagnosed with Acute Myocardial Infarction

Risk factors are the conditions that increase a patient’s chances of developing a disease. Modifiable risk factors are those that a patient can take proactive measures to change, while the individual can not alter the non-modifiable since they result from causes beyond their control.

The modifiable risk factors for coronary artery disease (CAD) include tobacco, diabetes mellitus, and hypertension. These are lifestyle-related conditions that a patient can change via lifestyle modification, i.e., a change in diet, engaging in physical activity, and doing away with smoking. The non-modifiable risk factors are a patient’s age, family history that causes a genetic predisposition, and gender.

On the other hand, the modifiable risk factors for Acute Myocardial Infarction are dyslipidemia, diabetes mellitus, hypertension, stress, and tobacco. The non-modifiable risk factors include gender and age (Mythili & Malathi, 2018).

What I Would Expect to See on the Patient’s EKG and the Findings Compatible with Acute Coronary Event

The EKG should show a T-wave inversion. I would expect these results due to increased myocardial inflammation in the heart and augmented left ventricular overload from a potential left ventricular enlargement from the increase in the size of its cells. In addition, I would anticipate observing either an ST-segment elevation or depression typical in myocardial infarction.

On the other hand, the patient’s clinical manifestations consistent with an acute coronary event include chest discomfort while playing tennis with a friend, a crushing sensation in the sternal area, and a pain that seemed to spread upward into his neck and lower jaw.

The Most Specific Test to Confirm the Acute Myocardial Infarct

The biomarker test that assesses Myoglobin is the most specific test I would choose to confirm acute myocardial infarct. Dlugasch & Story (2019) state that the test is highly sensitive and allows MI detection within two hours. The test can also detect reperfusions. The test is viable within one hour from the onset.

The Patient’s Temperature

Patient’s often experience fevers between 24-48 hours from the onset of an event. The fever can continue up to the fourth or fifth day. When fever occurs, it causes an increase in body temperature. Primarily, a discharge of inflammatory markers into the bloodstream causes the rise in prostaglandin E2 in the hypothalamus, resulting in higher body temperatures (Smid et al., 2018).

Why The Patient is Experiencing Pain During his Myocardial Infarction

Mr. W.G is experiencing pain due to a sudden blockage of coronary artery blood flow, reducing the amount of oxygen supply and causing the buildup of lactic acid and metabolic waste products such as adenosine and reactive oxygen species ( Dlugasch & Story, 2019). This buildup excited nerves that correspond to the same dermatome as the heart, causing the pain to radiate to other parts of the patient’s body, like the lower jaw.

 

References

Arumugham, V. B., & Shahin, M. H. (2021). Therapeutic Uses Of Diuretic Agents. In StatPearls [Internet]. StatPearls Publishing.

Dlugasch, L., & Story, L. (2019). Applied pathophysiology for the advanced practice nurse. Jones & Bartlett Learning.

Khalil, H., & Zeltser, R. (2022). Antihypertensive medications. In StatPearls [Internet]. StatPearls Publishing.

Kumar, A., Sharma, E., Marley, A., Samaan, M. A., & Brookes, M. J. (2022). Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ open gastroenterology, 9(1), e000759.

Mythili, S., & Malathi, N. (2018). Diagnostic markers of acute myocardial infarction. Biomedical reports, 3(6), 743-748.

Shah, N., & Gossman, W. (2019). Omeprazole. In StatPearls [Internet]. StatPearls Publishing.

Smid, J., Scherner, M., Wolfram, O., Groscheck, T., Wippermann, J., & Braun-Dullaeus, R. C. (2018). Cardiogenic causes of fever. Deutsches Ärzteblatt International, 115(12), 193.

Edited by Mosley-Lee, Jacara Danielle on Oct 25 at 11:58am