NUR 502 Week 2 Hematopoietic Factors Iron Deficiency Discussion St Thomas University

NUR 502 Week 2 Hematopoietic Factors Iron Deficiency Discussion St Thomas University

AP2 Case study 2a Case study: Hematopoietic

  1. Name the contributing factors on J.D. that might put her at risk to develop iron deficiency anemia.

There are several contributing factors from the provided patient history that might point to iron deficiency anemia. For instance, the patient had four pregnancies over a four-year period, which may have resulted in a considerable amount of blood loss at delivery  (Garzon et al., 2020). Six days of intense menstrual pain and heavy bleeding that result in a large blood loss compared to usual might expose the patient to anemia. Last but not least, the patient states that she has had intermenstrual bleeding for the last two months, which clarifies that menorrhagia is likely to be present if the patient reports menstrual blood lasting more than seven days. These elements contribute to considerable blood loss, which may have put the patient at risk for anemia.         

  1. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.

The anemia brought on by blood loss may play a significant role in the patient’s symptoms of dehydration. At times, changes in the body’s hormone levels, notably those of estrogen and progesterone, might cause constipation and dehydration issues. In another scenario, hormones could have an impact on the patient’s dehydration levels, causing variations that make them feel thirsty and make them dizzy (Igbinosa et al., 2022). Consequently, the major reasons for the patient’s dehydration and constipation might be changes in hormone levels brought on by bleeding.

  1. Why Vitamin B12 and folic acid are important in erythropoiesis? What abnormalities their deficiency might cause in the red blood cells?

The process of producing new erythrocytes is referred to as erythropoiesis. The old, damaged erythrocytes are replaced by the new ones, which are phagocytosed. Iron, folate, and vitamin B12 are essential for the erythropoiesis process, which produces new erythrocytes  (Takahashi, 2022). A lack of either folate or vitamin B12 prevents the purine and thymidylate synthases from working properly, which prevents erythroblasts from proliferating throughout their differentiation. This results in erythroblast death, impaired DNA synthesis, and anemia owing to inefficient erythropoiesis. Large levels of iron are necessary for erythroblasts to operate properly and aid in the manufacture of hemoglobin. The absence of appropriate amounts of vitamin B12 and folate can cause certain major abnormalities in the red blood cells, including those that cause the red blood cells to seem smaller than usual and pale in color.

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  1. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia. To support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.

Patients with mild forms of iron deficiency anemia may go undetected at first. Yet when the condition progresses, iron deficiency anemia might be identified by clinical signs including excessive weariness, pale complexion, weakness, chilly hands and feet, chest discomfort, a rapid heartbeat, or shortness of breath, as well as strange cravings for things like ice, dirt, or starch  (Garzon et al., 2020). These symptoms, which have also been described in the patient undergoing examination, may be a sign of iron deficiency anemia. The most frequent cause of anemia in patients is iron deficiency, which is brought on by a reduced supply of iron from heme synthesis and affects the growth of erythroid cells’ ability to make hemoglobin. Hence, decreased hemoglobinization leads to the generation of erythrocytes that are smaller than usual (microcytic) and have fewer hemoglobin molecules (hypochromic). Blood loss, which in this case results from 6 days of high flow and intermenstrual bleeding, is the primary cause of iron deficiency anemia.       

  1. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.

Iron deficiency anemia, which results from a shortage of iron in the body to produce hemoglobin to carry oxygen to and from bodily tissues and cells, is mostly characterized by unusual exhaustion or fatigue. Fewer oxygen results in reduced energy. Paleness is another indicator of iron deficiency anemia and results from a decrease in hemoglobin levels in the blood (hemoglobin is responsible for the red color of the blood)  (James, 2021). The third indication of iron deficiency anemia, which occurs when there is a lack of hemoglobin and a consequent reduction in the quantity of oxygen obtained, is shortness of breath. This is done by speeding up breathing to make up for the lack of oxygen in the blood. Due to inadequate hemoglobin in the blood lowering the quantity of oxygen reaching the brain cells, individuals with iron deficiency anemia also experience headaches, lightheadedness, and dizziness, which causes the blood vessels in the brain to bulge and produce pressure to stimulate greater blood flow. Heart palpitations are also prevalent as a result of increased blood oxygen demand, which causes the heart to beat more rhythmically. These are the main symptoms that individuals with iron deficiency anemia might see.

  1. Lab results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe appropriate recommendations and treatments for J.D.

Hb 10.2 g/dL, Hct 30.8%, and Ferritin 9 ng/dL are confirming tests for iron deficiency anemia, according to the lab findings  (James, 2021). If the measurements go below the cutoff, iron deficiency anemia is verified. For example, Hb 10.2 g/dL is under the usual threshold of 13.5 g/dL, Hct 30.8% is within the typical ranges of 36%–44% for women, and Ferritin 9 ng/dL is under the recommended ferritin of Ferritin 10 ng/dL. (Miller, 2013). These results confirmed the patient’s iron deficiency anemia. There are several approved therapies.

It is advised to adjust one’s diet to promote the consumption of iron-rich foods like green leafy vegetables (such as spinach), meat, especially organ meats like liver, legumes (such as beans and peas), fish (such as sardines and anchovies), and iron-enriched cereals and plates of pasta. It is suggested to take 150–200 mg of elemental iron daily in the form of daily multivitamin supplements, however, the patient should be made aware of certain serious side effects (Igbinosa et al., 2022). Moreover, intravenous iron may be used to treat patients with severe iron shortage, persistent blood loss, or gastrointestinal issues that prevent them from absorbing iron in the digestive system. Patients with severe anemia due to iron deficiency may need blood transfusions, especially if they exhibit symptoms like weakness or chest discomfort.

NUR 502 Week 2 Hematopoietic Factors Iron Deficiency Discussion St Thomas University References

Garzon, S., Cacciato, P. M., Certelli, C., Salvaggio, C., Magliarditi, M., & Rizzo, G. (2020). Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem. Oman Medical Journal35(5), e166–e166.

Igbinosa, I., Berube, C., & Lyell, D. J. (2022). Iron deficiency anemia in pregnancy. Current Opinion in Obstetrics and Gynecology34(2), 69–76.

James, A. H. (2021). Iron deficiency anemia in pregnancy. Obstetrics & Gynecology138(4).

Takahashi, A. (2022). Role of Zinc and Copper in Erythropoiesis in Patients on Hemodialysis. Journal of Renal Nutrition.

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