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#1 Abigayle
Hematopoietic Case Study
Risk Factors for Iron Deficiency Anemia
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#1 Abigayle
Hematopoietic Case Study
Risk Factors for Iron Deficiency Anemia
The risk factors for iron deficiency anemia that the patient in the case study presented include being a female of childbearing age, taking an excess amount of Ibuprofen which could be causing bleeding, having significant prior physical trauma, and excess blood loss due to heavy menstrual cycles and bleeding in between cycles (American Society of Hematology, 2020).
Possible Causes of Dehydration and Constipation
The patient in the case study presented denies constipation and dehydration, however, she may be experiencing a combination of both issues. J.D. is at risk for dehydration due to taking a diuretic to manage her hypertension. J.D. may experience constipation because she is taking Omeprazole to attempt to counteract GI side effects associated with the amount of Ibuprofen she is taking daily. Omeprazole can cause constipation (Lobello, 2022).
Symptoms Supporting Diagnosis of Iron Deficiency Anemia
The gynecologist suggests that J.D. may have iron deficiency anemia due to her reports of heavy menstrual bleeding and cramping for six days, complaint of extreme fatigue, weakness, and low energy levels reported since before her last pregnancy (American Society of Hematology, 2020).
Signs of Iron Deficiency Anemia
If a patient is diagnosed with iron deficiency anemia, some signs that can be exhibited include pale skin, fast heart rate, cyanosis of the sclera of the eyes, spoon shaped nails, and stomatitis ((Dlugasch & Story, 2021, pg. 100). A patient may only exhibit one or many signs, however, diagnostic lab tests can assist in positive diagnosis of iron deficiency anemia. Serum ferritin and iron levels will be low and transferrin and TIBC will be high on bloodwork.
Treatment Recommendations
J.D. is exhibiting iron deficiency anemia based on her lab results and signs and symptoms presented. As the healthcare provider, I would recommend that the patient stop taking Ibuprofen daily for her knee pain immediately. I would recommend her to switch to a pain medication that does not increase risk of bleeding, such as Acetaminophen. As far as treatment options, I would recommend the patient start taking daily iron supplements, as well as a stool softener to prevent constipation. Iron deficiency anemia is often treated by increasing the amount of iron in the body by oral iron supplements and increasing the intake of iron rich foods such as leafy greens (Dlugasch & Story, 2021, pg. 102.
Cardiovascular Case Study
Risk Factors for Coronary Artery Disease and Myocardial Infarction
There are risk factors for developing coronary artery disease and myocardial infarction, some of which are modifiable and others that are non-modifiable. Many risk factors can be reduced by managing stress levels, maintaining normal weight, staying active, eating healthy, maintaining normal cholesterol and blood pressure levels, and avoiding tobacco (Dlugash & Story, 2021, pg. 163). A non-modifiable risk factor for coronary artery disease and myocardial infarction is the diagnoses of diabetes mellitus.
EKG Findings During an Acute Myocardial Infarction
The patient in the case study presented is diagnosed with an acute myocardial infarction. It is expected that this patients EKG would reveal ST segment elevation. However, the patient could still have a regular EKG with no abnormalities, and only reveal a myocardial infarction through laboratory tests, such as cardiac enzymes.
Laboratory Test to Confirm Acute Myocardial Infarct
If I could choose only one laboratory test to confirm an acute myocardial infarction would be Troponin I. There are other cardiac enzymes that can be tested, such as CK-MB levels, however, Troponin I is the most specific diagnostic marker of myocardial injury.
Temperature Changes After Myocardial Infarct
A patient that has experienced an acute myocardial infarction may have an increase in body temperature due to the body’s natural inflammatory reaction. An elevated body temperature after myocardial necrosis is the body’s response to start trying to repair the myocardium. The increase in body temperature after acute myocardial infarction can start within four to eight hours after the onset of symptoms, and can last up to five days.
Pain Associated with an Acute Coronary Event
Pain occurs during an acute myocardial infarction due to the heart muscle cells not getting enough blood.
#2 Angelica Maria
Iron deficiency anemia.
First, we need to understand quickly what Anemia means. So, our body does not receive enough blood that is rich in oxygen if we have Anemia. Therefore, weakness or fatigue may result from low oxygen levels. In addition, we can get headaches, dizziness, trouble breathing, and irregular heartbeat eventually. Reviewing Ms. J.D.’s signs and symptoms, the contributing factors J.D. that might put her at risk of developing iron deficiency anemia are her 2-month history of intermenstrual bleeding, menorrhagia, her six days of heavy flow, extreme fatigue, and weakness. (Pasupathy et al., 2023).
Constipation and or Dehydration
Constipation might be due to her last pregnancy, and we might need to remember that constipation might occur after giving birth because the bowel itself may have been injured by labor and become sluggish. At the same time, the abdominal muscles stay enlarged throughout birthing, flaccid and momentarily ineffectual. Furthermore, we need to realize that our patient, Ms. J.D., has not had a break of at least two years between her pregnancies, where the thinking about her hormones from nursing can be a cause of constipation due to a shift in hormone concentrations, such as Progesterone levels; they are raised during breastfeeding. Thus, this hormone can lead to constipation by slowing the “transit time” in the intestines. Likewise, during her assessment, our patient has a history of Osteoarthritis, and recall, we also have an intestinal health impact since people with Osteoarthritis frequently experience poor bladder and bowel control, which can have a detrimental impact on their quality of life. Additionally, Ms. J.D. takes Ibuprofen in large quantities. If we recognize the adverse effects of Nonsteroidal anti-inflammatory medicines (NSAIDs), one of the possible results is gastrointestinal issues like constipation due to the higher dosages of Ibuprofen. Moreover, blood pressure drugs can be another detonating since numerous blood pressure drugs, such as beta-blockers and calcium channel blockers, can slow down the digestive tract, which can cause constipation. Finally, Ms. J.D. is on diuretics, and one of the most substantial adverse effects besides electrolyte imbalance is dehydration. (Tatiana et al., 2022).
Vitamin B12, Folic acid, and Erythropoiesis
Millions of new red blood cells are created daily to replace aging, deteriorating ones. Food-based nutrients like iron and vitamins like B12 and folate (folic acid) support the body’s ongoing cell formation. Therefore, the enzyme Methionine Synthetase, which catalyzes the Folic Acid reaction, requires vitamin B12 to function. Consequently, these two aids in cellular function and tissue growth by assisting the body in using and forming new proteins and breaking down existing proteins in concert with vitamin C. Therefore, it assists in the production of red blood cells, preventing anemia. Consequently, the deficiency might cause red blood cell anemia. It is brought on by folic acid and vitamin B12 deficiency, where the bone marrow makes big, aberrant red blood cells called megaloblastic anemia, megaloblasts (Gonzo et al., 2021).
Iron deficiency anemia.
Anemia is when the blood does not contain enough healthy red blood cells. Thus, one common type of anemia is iron deficiency, where the body’s tissues receive oxygen from red blood cells. Additionally, iron deficiency anemia, as the name implies, is brought on by a low iron level. Consequently, someone with mild or moderate iron deficiency anemia can be symptomless. Nonetheless, a person with iron deficiency anemia might have chest pain, exhaustion, and shortness of breath, which are frequent symptoms brought on by more severe iron deficiency anemia; we could also have signs and symptoms of fatigue. As a result, our patient, Ms. J.D. has had for the last couple of months extreme fatigue and weakness that corroborate the diagnosis of Iron deficiency anemia. (Pasupathy et al., 2023).
Signs of Iron deficiency anemia.
Patients with iron deficiency anemia would exhibit dizziness, fatigue, lethargy, lightheadedness, or malaise. Also, brittle nails, hair loss, headache, irritability, restless legs syndrome, or shortness of breath. This is because our body does not receive enough blood that is rich in oxygen if we have anemia. Hence, weakness or fatigue may result from low oxygen levels. (Pasupathy et al., 2023).
Recommendations and treatments for Iron deficiency anemia.
Ferritin levels indicate and measure stores of iron; it makes iron available for our body to be used as needed. Consequently, a ferritin test indirectly measures the amount of iron in the blood. Regarding Ms. J.D.’s Hemoglobin levels, Hematocrit, and Ferritin, we can tell that she has a deficiency of iron; where her best treatment is iron supplements, sometimes known as oral iron or iron tablets, which aid in raising the amount of iron in our body; the most popular course of treatment for iron-deficient anemia is this one. It is worth adding that restoring our iron levels typically takes three to six months. Additionally, we can offer Ms. J.D. to increase her iron intake in her diet, such as lentils, dried vegetables, dehydrated fruits, eggs (especially yolks), and cereals fortified with iron, liver, lean red meat (especially beef), oysters, poultry meat, dark red meats. (Pasupathy et al., 2023).
Modifiable and non-modifiable risk factors.
There are two risk factors for cardiovascular illness: modifiable and non-modifiable. The modifiable ones can be changed, such as sedentary behavior, high blood pressure, obesity, smoking, diabetes, and hypercholesterolemia. On the contrary, risk variables that are not changeable are uncontrollable, such as elder age, race, gender, and family background. Also, age, sex, and family history are considered non-modifiable (Gall et al., 2023).
Acute coronary event
ST-segment elevation is the pattern of injury seen on the EKG in cases of myocardial infarction where an abrupt blockage of the coronary artery causes an infarction, which results in highly severe ischemia and, ultimately, irreparable myocardial necrosis. Also, in acute coronary syndrome, P wave and QRS morphological changes, besides the previous ST. We would have T-segment alterations that are associated with a poor prognosis (Matijasich et al., 2023).
Troponins
A particular protein called troponin is present in the heart’s muscles. Troponin is usually absent from the blood and appears to damage the cardiac muscle, causing it to release troponin into the circulation. Therefore, more troponin is released into the circulation as cardiac injury grows (Nissen et al., 2023).
Myocardial Infarct
Because postinfarction fever is linked to increased blood levels of cardiac enzymes and C-reactive protein, it has been identified as a nonspecific reaction to significant myocardial injury (Matijasich et al., 2023).
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