Week 8-Ch 30 Case Study - Anemia PDF

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notes on anemia
this is just a short case study that allows you to test your knowledge...

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Case Study Chapter 30 Hematologic Problems Anemia approx 30 min Patient Profile D.G., a 72-year-old man whose wife died 6 months ago, is brought to the health care provider by his daughter because he is not eating much and has been lethargic and sleeping a lot. He has a history of hyperlipidemia for which he takes niacin–lovastatin 500/20 mg PO daily at bedtime. Subjective Data Has been unusually tired for the past couple of months Is frequently short of breath and sometimes feels like his “heart is pounding”  Has lost weight because his wife always used to cook for him, and he doesn’t cook for himself  Describes a typical daily meal as coffee and a donut for breakfast, a hot dog and lemonade for lunch, and a jelly sandwich on white bread and coffee for supper  

Objective Data Physical Examination   

Blood pressure 118/72, pulse 98, temperature 98.2°F, respirations 16 Oxygen saturation 92% on room air Height 5'6", weight 135 lb, BMI 21.7 kg/m²

  

S1 and S2 auscultated and regular Bilateral radial pulses +3 and regular Lungs clear bilaterally

Diagnostic Studies * * * * * * * * * * *

RBC Hemoglobin Hematocrit MCV MCH WBC Platelets Iron Ferritin Cobalamin Folate

3,300,000/µL 8.3 g/dL 24% 73 fL 23 pg 9100/µL 250,000/µL 28 mcg/dL 14 ng/mL 600 pg/mL 10 ng/mL

Question 1 Interpret D.G.’s laboratory results. RBC-low Hemoglobin- low MCV-low MCH-low WBC- within range Platelets- within range Iron- low Ferritin – low but within range Cobalamin- within range Folate- within range

Question 2 Based on the laboratory data and assessment findings, the health care provider diagnoses D.G. with iron-deficiency anemia. What clinical manifestations of iron deficiency anemia does D.G. have? Tiredness, weakness.

Question 3 Explain iron-deficiency anemia and identify the probable cause of D.G.’s anemia. This is an insufficient amount of iron in the blood. With not enough iron in the blood there is not enough oxygen carried throughout the blood stream. He most likely has anemia because he is not eating the correct nutrition now that his wife is not cooking for him.

Question 4 How is iron-deficiency anemia treated? Doctor may prescribe iron supplements. This is the most common treatment.

Question 5 Identify dietary iron sources to include in D.G.’s teaching.

Breakfast cereal, white beans, spinach, chickpeas, green peas, white bread, milk, cheese, chicken, liver.

Question 6 What are important points to include when teaching patients taking oral iron supplements? Should not be taken with food, should be taken 1 hour prior or 1 hour after eating a meal. Take iron 2 hours prior to any antacids or 4 hours after.

Question 7 What evaluative parameters could you use to determine whether D.G.'s anemia is resolving? If he has more stamina during the day, if he has more energy than before treatment. And if his laboratory values return to a more normal range....