Iron Deficiency Anemia Essay Paper
Subjective Data
Chief Complaint: “I am always tired and cold. I also feel weak, lightheaded and dizzy. Sometimes my heart feels like it will jump out of my body.”
History of Presenting Illness: D.M is an 18-year-old Latino American who presented with complaints of extreme tiredness and feeling cold. The fatigue began some months ago when she started college as a freshman. Recently, the fatigue has become more constant making it difficult for her to keep up with classes especially as a freshman in a community college. The symptoms of fatigue and coldness are associated with occasional dizziness, lightheartedness, general body weakness, and palpitations. Iron Deficiency Anemia Essay Paper
Medications: Tylenol for occasional pains and aches
Past Medical-Surgical History: denied any serious chronic illnesses, she underwent an appendectomy at 13 years of age.
Gynecological -LMP-Now, irregular, heavy and frequent flow
Allergies: No known drug or food allergies
Immunizations: up to date with all other immunizations apart from the HPV vaccine.
Family History: The client denied the history of chronic familial illnesses. Both her parents are alive and well. Mother is 36 years old while the Father is 37 years old. She has one female sibling who is 13 years old alive and well.
Social History: The client lives with her parents and sister in a 4 bedroom home and attends college full time. The client denied using tobacco or alcohol, denied experiencing any stress related to school or family and denied sexual activity.
Review of Systems
HEENT-denied changes in vision, eye pain, headache or blurred vision
Gastrointestinal-denied dyspepsia, N/VD
Respiratory System-denied chest pains, dyspnea, palpitations or pressure
Genitourinary System-denied burning on urination, vaginal itching, painful or frequent urination and changes in bowel habits, present periods have persisted are irregular, heavy and frequent but with no cramping, pelvic pain or strong odor.Iron Deficiency Anemia Essay Paper
CNS- acknowledged dizziness, fatigue, and lightheadedness
Cardiovascular- complained of a rapid and heavy heartbeat
Musculoskeletal– has occasional muscle aches and generalized weakness, denied joint pains.
Objective Data
Physical Examination
Vital signs-Height 5’4”, weight 119, BMI-20.4, Temp 98.8, pulse-104bpm, respiratory rate-18 cycles/min, BP130/80mmHg
Skin– no bruising or tender enlarged nodes noted, normal color, hands are pale with a capillary refill of less than 3 seconds
CVS– Rapid and regular heart rate, SI and S2 heard with no murmurs
RS- moves symmetrically with inhalation and exhalation, bilateral CTA
CNS-PEBRL, AOX3, all cranial nerves intact
Pelvic-patient has per vaginal bleeding, odorless dark red blood in a fully soaked pad, no unusual discharge noted, manual exam reveals no unusual motion tenderness, rash, polyps or lesions on the genitalia and the cervix.
Assessment
Primary Diagnosis
Iron Deficiency Anemia (D50.9): the client is an18 year old who was on her monthly menses at the time of presentation. As described her menses were heavy, frequent and irregular. Ladies of reproductive age who have heavy and frequent menstruation lose a lot of blood thus, are at an increased risk of iron deficiency anemia (Peuranpää et al., 2014). Besides, the patient, in this case, had the complaints of dizziness, fatigue, general body weakness and feeling extremely cold. These classical signs are due to low hemoglobin content in the blood. Therefore, the overall capacity of oxygen transported to vital organs and tissues in the blood is generally low to meet the body’s demands (Shander et al., 2014).Iron Deficiency Anemia Essay Paper
Differential Diagnoses
Inadequate dietary Iron Intake (D50.8): inadequate dietary intake of iron can also result in iron deficiency anemia. This can occur due to issues in food absorption or food intake. However, among women of reproductive age, it can rarely be the single cause of iron deficiency anemia (Camaschella, 2015).
Anemia of Chronic disease (D63.8) – Anemia of chronic disease is a type of microcytic anemia with a similar clinical presentation to iron deficiency anemia. However, its diagnosis requires that a patient should have an underlying chronic illness, cancer or autoimmune disease that impairs the production of red blood cells (Poggiali, De Amicis & Motta, 2014). However, in this case, since the patient had no underlying chronic illness, it is a less likely diagnosis.Iron Deficiency Anemia Essay Paper
Plan
Management Plan
Diagnostic Tests
The patient will have to undergo the following tests to confirm the primary diagnosis
Complete Blood Count: a low mean cellular volume (MCV), low Hb level (Hg) and Hct (hematocrit) will confirm this diagnosis (Peuranpää et al., 2014). Based on the level of severity, the WBC count may also below.
Iron Studies: low ferritin levels, low serum iron, low iron saturation levels, a high TIBC (total iron-binding capacity) and high levels of transferrin likely suggest iron deficiency anemia.
Medications: The patient will be started on ferrous sulfate tabs 300-325mg TID for six months. The patient will be encouraged to take the ferrous sulfate daily before meals with orange juice. Orange juice promotes the absorption of ferrous sulfate (Camaschella, 2015). Should the patient be intolerant to oral iron intake the parenteral iron infusion will be considered.
Comfort Measures: The patient will be asked to regularly change her pads and keep a log of the number of pads used on a daily basis. She will also be encouraged to increase her dietary iron intake to boost the blood iron levels. This will best be achieved through collaboration with a nutritionist for nutritional guidance and support on the most recommended foods rich in iron such as liver, fish among others (Camaschella, 2015). Apart from being advised to avoid overusing painkiller medications, the client will be advised to only engage in light physical exercises and activities.
Follow-up-The client will have to return to the clinic in one week to assess if bleeding has reduced and the effectiveness of the prescribed medications. Therefore, a series of tests including a CBC and iron studies will routinely be conducted.Iron Deficiency Anemia Essay Paper
Referral-It will be necessary to refer the client to a gynecologist for further evaluation and assessment. The gynecologist may consider admitting the patient for a blood transfusion and later prescribe her control pills to regulate the heavy periods.
References
Camaschella, C. (2015). Iron-deficiency anemia. New England journal of medicine, 372(19), 1832-1843.
Peuranpää, P., Heliövaara‐Peippo, S., Fraser, I., Paavonen, J., & Hurskainen, R. (2014). Effects of anemia and iron deficiency on quality of life in women with heavy menstrual bleeding. Acta obstetricia et gynecologica Scandinavica, 93(7), 654-660.
Poggiali, E., De Amicis, M. M., & Motta, I. (2014). Anemia of chronic disease: a unique defect of iron recycling for many different chronic diseases. European journal of internal medicine, 25(1), 12-17.
Shander, A., Goodnough, L. T., Javidroozi, M., Auerbach, M., Carson, J., Ershler, W. B., & Lew, I. (2014). Iron deficiency anemia—bridging the knowledge and practice gap. Transfusion medicine reviews, 28(3), 156-166.
Anemia is a condition where the human body does not have sufficient and healthy red blood cells. Iron is a very crucial element for red blood cells. When the human body does not have sufficient iron, it will make less red blood cells or small red blood cells. This is what amounts to iron deficiency anemia. Iron deficiency anemia is a very common anemia. Red blood cells transport oxygen to the tissues of the human body. Healthy red blood cells are manufactured in the bone marrow. Red blood cells move through the human body for a period of between 3 to 4 months. Parts of the human body are then responsible for removing old red blood cells. Iron is a very essential part of the red blood cells. The lack of iron in the body causes ineffective transportation of oxygen (Alleyne, Horne and Miller, 2008). The human body normally gains iron through the diet taken in and using iron from the old red blood cells again. Iron deficiency anemia is realized when the iron stores of the human body run low.Iron Deficiency Anemia Essay Paper
Generally, iron deficiency can be realized in the event that more blood cells and iron are lost than the human body is in a position to replace (Brittenham, 2008). Again, when the human body does not function well in iron absorption, iron deficiency can result. Another situation is the point where the human body is in a position to absorb iron while foods with iron are not being taken in. The human body requires more iron than ordinary for instance in the case of a pregnant or a breastfeeding mother. Iron can also be lost through bleeding. This bleeding can be realized through long, heavy and frequent menstrual periods, stomach, colon and esophagus cancer, the use of certain medicines like ibuprofen, aspirin or arthritis for a long period or even through peptic ulcer disease. The absorption of iron by the body may also be hindered by celiac disease, gastric bypass surgery, Crohn’s disease and the consumption of very many antacids with calcium. A strict vegetarian may also not get enough iron. An older adult who does not eat a full diet may also not get enough iron (Alleyne et al., 2008).
Iron deficiency anemia can be managed and treated by taking supplements as well eating foods rich in iron. All the same, an individual effort and the health care provider should first seek to establish the cause of the condition. Iron supplements usually ferrous sulfate are required to build up the stores of iron in the human body (Mabry-Hernandez, 2009). Patients who can not take iron via the mouth can inject it into the body through the muscle. Breastfeeding and pregnant mothers can take in extra iron since their usual diet normally will not offer the amount required.Iron Deficiency Anemia Essay Paper
2. Cardiomyopathy and Congestive Heart Failure
For Mr. P, needs more than he needs more than the prescribed treatment. Drugs like ACE inhibitors could be useful and other invasive procedures like pacemakers. However these measures can only improve survival and not essentially the quality of life (Quaglietti, Atwood, Ackerman and Froelicher, 2000). Vesnarinone therapy could be useful in improving quality of life at the expense of having long life. Mr. P is contemplating suicide. Automatic implantable cardioverter delibrillators (AICD) and cardiac pacemakers are common therapies that can be applied to him as they deter death from lethal arrhythmia’s. The deactivation issue of AICD could come up in Mr. P. Preferences of either survival or quality of life however, will be imperative when discussing the treatment options for Mr. P. At this point, survival is important for the wife who shows sadness due to Mr. P’s condition.
The management of this condition needs an interdisciplinary team to deal with psychological, spiritual, medical and social needs as demonstrated by Mr. P. A care model with a collaborative effort that coordinates care along with the positive wish of the patient, management of symptoms to deter exacerbations, sustenance of function and quality of life with good hospice care, education of the patient with concentration on management prelerences, and support from the family, particularly in this situation where Mr. P is contemplating death. In this treatment approach, adequate coverage on a 24-hour basis will be included.Iron Deficiency Anemia Essay Paper
Apart from the care directed to this condition, Mr. P needs palliative and end-of-life care. There are quite a number of issues that come with the planning of end-of-life care for patients with CHF like Mr. P. Hospice care was conventionally given to patients of cancer. However, hospice agencies have started to tailor prognosis standards for other chronic diseases like CHF (Quaglietti et al., 2000). A prognosis of about six months would be useful in enrolling Mr. P in a hospice program. All the same, the patient must consent to non-aggressive care. However, predictions of death timings for CHF can be difficult. Deaths can emerge from strokes, arrhythmias, infection or myocardial infarction. For hospice care to be provided, the patient should consent to palliative care. This terminal care is normally exclusive mutually and different from treatments that cure the main disease or treat the underlying psychophysiology.
It would also be important to educate the patient and the family while providing logical reasoning on CHF. This will help in being positive towards treatment. The teaching plan will entail the following.
Heart Failure Process: it means that the heart is not pumping as required and that continuous treatment coupled with good lifestyle can correct the situation; Rationale: – Many old age people and other adults don’t comprehend the chronic disorders concept that cannot be cured and continue to seek for a medication to deal with the problem.
Blood Pressure Monitor: Mr. P should be encouraged to use home blood pressure device. Blood pressure parameters should be obtained from health care provider while records of the same are kept. Rationale: – Parameters of blood pressure differ with persons. Heart failure could be out of control when blood pressure is higher or lower than normal.Iron Deficiency Anemia Essay Paper
Plan and eat foods with prescribed sodium limits: salty foods and high-sodium foods like anchovies and processed meats like sausage should be avoided. Pepper, lemon, or garlic can help. Rationale: – Sodium makes the human body hold on to fluid. Therefore, the heart has to work tirelessly to pump the fluid that has been added.
Iron Deficiency Anemia: Case Study
According to details of the case study, Mr. A suffers from iron deficiency anemia. Iron deficiency anemia is the most common type of anemia. This is a state where the blood lacks enough red blood cells (Clark, 2008). When the number of erythrocytes is small, oxygen becomes less likely to be carried to various parts of the body. Iron deficiency is anemia due to iron deficiency in the body. Without enough iron in the body, hemoglobin is the main carrier of oxygen, so it can not produce enough hemoglobin and low levels of oxygen can cause fatigue and shortness of breath (Cop stead, Banasik , 2010).
Unfortunately, once suffering from iron deficiency anemia, iron intake during a meal is not enough to correct deficiency. Oral iron supplements are the main treatment for iron deficiency anemia. Please consult your health care professional before taking an anemic supplement. Since there are various types of anemia for various reasons it is important to confirm that you are treating the right kind of anemia and its underlying cause.Iron Deficiency Anemia Essay Paper
According to details of the case study, Mr. A suffers from iron deficiency anemia. Iron deficiency anemia is the most common type of anemia. This is a state where the blood lacks enough red blood cells (Clark, 2008). When the number of erythrocytes is small, oxygen becomes less likely to be carried to various parts of the body. Iron deficiency is anemia due to iron deficiency in the body. – In risk factor observation studies, constipation patients were not directly related to diverticulitis. Patients with frequent defecation have a higher risk of diverticulitis (Sames, 1970). The risk of diverticulitis increases with age. Changes due to age such as a decrease in elasticity of colon wall contribute to the formation of diverticulitis
Iron deficiency anemia If your body does not have enough iron, your body does not produce enough red blood cells. Iron deficiency anemia is the most common form of anemia. Causes of iron deficiency include lack of iron intake, sudden loss of blood, long-term blood loss (such as severe period of menstruation), or failure to absorb enough iron from food. Sickle cell anemia In this hereditary disease, red blood cells are not a normal zigzag, but have a shape of a half moon. This change in shape may make the cell “sticky” and may not be able to flow smoothly through the vessel. This blocks the blood flow. This occlusion can cause acute or chronic pain and can cause infections and organ damage. Sickle cell dies much faster than normal blood cells – about 10 to 20 days rather than 120 days – red blood cells run short.Iron Deficiency Anemia Essay Paper