Running Head: CASE STUDY # 1

Case Study # 1: Anemia
Jyothi Malaickal
Grand Canyon University
Pathophysiology and Nursing Management of Client’s Health
NRS 410V
January 24, 2015

Case Study # 1; Anemia Anemia is a one of the most common blood condition that affects over 3 million people in the United Sates of America. Nursing case studies benefits the nursing professional in the process of diagnosis, treatment, planning and nursing interventions of patient that they care. It helps the nurses for critical thinking and also to resolve the health problems of patient’s. In the case study provided Ms. A. presents with symptoms of Iron deficiency anemia. Anemia is a medical condition where quality and quantity of hemoglobin and red blood cells (RBC) are decreased, which in turn decreases the oxygen carrying capacity of the blood to the body parts, tissues and organs. The normal level of hemoglobin in male and female are different. In men hemoglobin level less than 13.5gram/100ml and in women hemoglobin level less than 12.0gram/100ml is considered as anemia. The most common causes for anemia are RBC destruction, bone marrow dysfunction, acute, chronic blood loss, and nutritional deficit (Bryan &et al, 2012). Here the author explains and assesses Ms. A. and her presented signs and symptoms of iron deficiency anemia which is a common type of anemia affects young women of reproductive age.
Signs and Symptom of Iron Deficiency Anemia Malnutrition is the main cause of anemia. Iron deficiency anemia causes almost 841,000 deaths every year. Ms. A. has the signs, symptoms and lab values of iron deficiency anemia. Iron is the main component that helps the formation of hemoglobin. Hemoglobin is very important for transporting oxygen to the tissues, cells and organs of the body. Ms. A. states that she had 10-12 years of menorrhagia and her symptoms worsen during menstrual cycle. She also takes aspirin every day for joint stiffness. Chronic blood loss and imbalance in taking iron causes anemia. A decreased iron level after using up the stored iron, which causes decreased hemoglobin level and leads to decrease to iron carrying capacity of RBC’s. (Harrison, 2012). The most common signs and symptoms of iron deficiency anemia includes lack of energy, dizziness, less enthusiasm, shortness of breath, pale skin, fatigue, chest pain with activity, joint pain, hypotension and tachycardia. Mrs. A has most of these signs and symptoms. Tachycardia results the responses of tissue hypoxia, heart pumps faster to get oxygen to the vital organs and causes increased cardiac output. Restless legs syndrome, which is the tingling, joint pain or crawling feeling of the legs, can also happens due to this. Tinnitus, dyspnea on exertion, headache, palpitations, enlarged spleen, brittle nails, and unusual cravings for substances, like dirt, ice, and starch can be seen in severe cases of iron deficiency anemia. In addition Mrs. A takes aspirin, which inhibits the platelet aggregation and causes the bleeding (mayo clinic staff, 2012).
Laboratory Workup
Iron deficiency anemia is called as hypochromic or microcytic anemia. Diagnostic tests include lab works are done to confirm the diagnosis. A Complete blood count and iron profile can detect iron deficiency anemia. Ms. A has decreased levels of hematocrit, hemoglobin, erythrocyte count and increased reticulocyte count. It is because of chronic bleeding due to iron deficiency anemia. Hypochromic and microcytic red blood cells are seen in RBC smear. Peripheral blood smear examination always is very important to confirm iron deficiency anemia. Mrs. A’s RBC smear showed microcytic and hypochromic cells, which are indicative of, iron deficiency anemia. Because of the decreased amount of oxygen and hemoglobin, red blood cells becomes paler and smaller and are known as microcytic and hypochromic red cells. (Copstead & Banasik, 2010, P. 313). Decreased amount of hematocrit, serum ferritin and iron and the elevated total iron binding capacity (TIBC) and the high red blood cell distribution width are related to iron deficiency anemia. Low ferritin levels in the serum shows that the iron stores are depleted. Other diagnostic tests include colonoscopy; endoscopy, urine, blood and stool for occult blood are also done to detect the causes of blood loss (Facui et al., 2012).
Treatment of Iron Deficiency Anemia Iron deficiency anemia is treated with, iron supplements like ferrous sulfate and iron-rich foods. Iron supplements will help to build up the storage of iron in the body. Lab works like iron levels and hematocrit levels are checked periodically, to know the results of the medicines. Patients, who have problems with swallowing iron pills, are administered with iron injections intramuscularly or intravenously. Iron rich foods include fish, dried lentils, beans, peas, turkey, chicken, peanut, butter, soybeans, liver, oatmeal, whole grains, iron fortified cereals, raisins, prunes and apricots are advised by the providers. She must be educated about taking Vitamin C or drink orange juice with the iron pills will help the absorption of iron. RBC transfusion therapy is given at times to stabilize patient in severe cases of anemia (PubMed health, 2012). Conclusion Iron deficiency anemia can be treated by proper treatment, once the underlying cause is identified. With the right treatment, proper patient education, intervention, proper planning and care patient’s hemoglobin levels increases. Increased hemoglobin levels increases oxygen to cells, tissues and organs. . This helps the patients to alleviate their symptoms relate to anemia and return back to normal lifestyles.

Reference Mayo clinic staff (2012), Iron deficiency anemia/symptoms, Retrieved April10, 2013, from http://www.mayoclinic.com/health/iron-deficiency-anemia/DS00323/DSECTION=symptoms PubMed health (2012), Iron deficiency anemia Retrieved April10, 2013, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001610
Fauci, A. S., Longo, D. L., & Harrison, T. R. (2012). Harrison's principles of internal medicine18 (1) Chicago:McGraw-Hill/Appleton & Lange
Bryan, L., & Zakai, N. (2012). Why is my Patient Anemic? Hematology/Oncology Clinics Of North America, 26(2), 205-230.
Copstead, L. C., & Banasik, J. L. (2010). Pathophysiology. (4 ed.). St. Louis: W B Saunders Co