Case Study: Anemia

Fatigue: The growth and development of red blood cells in the bone marrow may be suppressed while having increase in the number of malignant plasma cells, which then cause low levels of red blood cells in the blood. This condition, know as anemia, can result in unusual fatigue or weakness.

Anemia is a disorder of the blood. It occurs when your body does not produce enough erythrocytes or red blood cells (RBCs). Without the erythrocytes oxygen can not be adequately delivered to the tissues and organs throughout the body. This will cause you to become weak and tired. A person may also experience headaches, skin pallor, and faintness. Your body may attempt to compensate for these symptoms by speeding up the heart rate and respiratory rate. This is the body’s attempt to return oxygen levels to normal(Thibodeau and Patton, 2005).

The most prominent cause of Iron Deficiency Anemia is bleeding. Blood loss from the Gastrointestinal Tract is a significant cause of anemia for both men and women. When blood is present in excrement, a gastrointestinal problem exists. Many times, people are unaware of these problems with their waste products. When they begin to feel the symptoms of anemia and undergo tests that determine that they are anemic, it begins the process of discovering more health problems. Anemia can serve as the precursor of certain diseases. There are many instances when it is merely a sign of severe disease such as a peptic ulcer disease, gastritis, hemorrhoids, angiodysplasis of the colon, and colonic adenocarcinoma (http://www.physsportsmed.com/issues/sep_96/browne.htm).

2. Which of the following terms refers to either a reduction in the quantity of hemoglobin or a reduction in the volume of red blood cells?

The C02 is low because of the low kidney function. This can also be caused by lung function as well.

As a provider, one will care for many patients that have different types of anemia. Anemia is not so much as a disease as a symptom of an underlying issue. Although there can be particular signs and symptoms associated with anemia, the basis of a diagnosis is from laboratory data. For the purpose of this discussion, I will evaluate a case study and give a differential diagnosis. I will also assess how patient history, physical exam, and lab reports support my diagnosis. I will explain the pathophysiology of the type of anemia and give causes and treatment options available.

People who have Myelodysplastic Syndrome may not experience symptoms at the beginning of the disease. However, there are three main signs that can develop and alert healthcare providers that something is wrong. One of these is a low red blood cell count, or Anemia. Most patients that have myelodysplastic syndromes exhibit this indicator when first diagnosed. A normal red blood count can vary between 4.0 and 6.1 million red blood cells per microliter of blood in the body, depending on the age and sex of the patient. A red blood cell count lower than normal is characteristic of Anemia (Cafasso, Jacquelyn, and Gotter). Not only is Anemia shown by constantly low hematocrit, but it can also be characterized by constantly low hemoglobin. A normal hemoglobin count is between 12.0 and 15.5 grams per deciliter of blood for females, and 13.5 to 17.5 grams per deciliter of blood for males. Levels lower than these show a low hemoglobin level (Mayo Clinic, Hemoglobin Test). Hemoglobin is the protein in blood that carries oxygen to the different tissues in the body.

Also known as normocytic anemia. This is the most frequent type of anemia most often happening to males over 85 years old. It is a common problem that occurs to men and women over 85 years old. Symptoms include and are caused by: a reduced production of normal-sized red blood cells even though presence of hemoglobin in the red blood cells is within the standard range; an increased production of HbS as is seen in sickle cell diseases; greater destruction and loss of red blood cells; an increase in plasma volume that is not compensated by anything else; a B2 (riboflavin) deficiency; and a B6 (pyridoxine) deficiency. (Brill & Baumgardner 2000).

If you feel down and scraped your knee, describe what each type of blood cell would be doing at the site of injury

It is a condition in which there are not enough healthy red blood cells to carry adequate oxygen throughout the body. Red blood cells are normally round and flexible the moves easily throughout the blood vessels but, in sickle cell anemia the red blood cell is sticky, rigid, and has a crescent moon shape. The irregular shape cells can get stuck in the small blood vessels, which can slow or block

These tests also help nurses and physicians to see the fluctuations that take place from time of admission. The patient came in with low RBC’s which may be caused by her chronic kidney failure. Erythropoietin is excreted by the kidneys to gather more red blood cells. When the kidneys are not functioning, this may inhibit the excretion of erythropoietin, causing a low red blood cell count. She also came in with low hemoglobin levels which indicates anemia which also goes hand in hand with her low red blood cell count because hemoglobin is a protein located within red blood cells that carries oxygen from the lungs to the body and tissues. E.M. lastly appeared to have low hematocrit levels this again, is associated with the patient's anemia this is the proportion of blood that contains red blood cells, and in this patient's case is very

This type of lab usually shows the general health of the patient and the current state of blood cells. One of the segments of this lab is white blood cell (WBC) count. In ES’s lab work it was shown that his WBCs were at 16,700, which is high on the scale (normal values are 5,000-10,000). Upon further assessment it was found out that patient was not in current infection state (which is one of primary reasons of high WBCs) but it was due to corticosteroid therapy that he was on. Additionally to WBCs count is included red blood cell (RBC) count, and RBCs in their turn include hemoglobin and hematocrit levels. Hemoglobin is a protein that binds to oxygen and helps it to transport it to cells. Hematocrit level is a way to measure the space that is being taken by red blood cells in the blood. In ES’s lab chart it was noted that RBCs were on low side of 4.5 million but are still within normal limits (normal values are 4.5-5 million). On other hand the hemoglobin levels were low, measured at 11.6 (normal levels are 14-18 in males). This puts ES on mild case of anemia. One medical journal state that “mechanisms of anemia in COPD are probably multifactorial. They may be anemia of chronic disease related to inflammation, iron and vitamin deficiency, comorbidities, hypogonadism or treatment related.” (Sarkar, M., Rajta, P. N., & Khatana, 2015). Another test that came up to

The next stimulation is Brittany who is five years old. She was African American and was diagnosed at six months with sickle cell anemia. She had stop taking her prophylactic antibiotic and as a nurse, are job is not to judge but to see why they stop their treatment. Then it’s our job to explain why they need their treatment and help them in whatever way possible to get that treatment for them. The patient came into the ER with vaso-occlusive crisis. I had no idea that’s what they called it when they had a complication of sickle cell anemia. This was in her right low leg. Sickle cell crisis occurs when the circulation of blood vessels is obstructed by sickled red blood cells, causing ischemic injuries such as the leg. I couldn’t image a

Rationale: The patient is showing signs of anemia. She presents with pallor skin, racing heart, and fatigue. The patient’s lab results also indicates anemia. Her hemoglobin, hematocrit, and MCV are below the normal level. The MCHC level is 25g/L, which is concerning for blood loss over time. Her serum iron is also low at 15mcg/dl. The lab results and presenting symptoms indicate iron deficiency anemia. The patient reports that she is a picky eater, and she does not eat many vegetables or meats. She also reports menses that last 7 days with two to three heavy days. According to Abrams (2017), heavy menstrual blood loss (>80 mL/month) increases risk for iron deficiency anemia. The treatment plan will include administrations of iron supplements and dietary management. It would be important to address the issues of heavy bleeding and dietary issues with the patient to optimize her plan of care.

Yes, her diet could have caused her to be iron deficient, but there are numerous other possible causative agents. If her diet is to blame, then her diet would need to be adjusted – while respecting her religious beliefs. One could ask the patient if her diet could be altered to include the foods that she has omitted, as the Seventh-Day Adventist Church supports doing what’s best for one’s health, including eating red meats and such medical interventions as blood transfusions (James, 2005).