Case Study 1: Anemia
Situation: The client is a 77 – year – old widow who relies on her late husband’s savings for all her expenses. Over the past few years, she has eaten less and less meat because of her financial situation and the trouble of preparing a meal “just for me”. She also has medicines to buy for the treatment of hypertension and arthritis. Over the past 2 to 3 months, she has felt increasingly tired, despite sleeping well at night. When she goes to the clinic, the doctor orders blood work. The lab results are as follows: WBC 7.6 thou/cmm, Hct 27.3%, Hgb 8.3 mg/dl, platelets 151 thou/cmm. RBC indices are mean corpuscular volume 65 cmm, mean corpuscular hemoglobin 31.6 pg, MCH concentration 35.1%, red cell distribution width
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* RBC mean corpuscular volume is low, When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias. * Red cell distribution width 15.6% is high calculation of the variation in the size of your RBCs. In some anemias, such as pernicious anemia, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW. * Iron 30 mcg/dl is low which may indicate anemia and chronic illness. * Ferritin 8 mg/dl is low which indicate people who have iron deficiency.
3. What type of anemia does the client have? * Iron deficiency anemia
4. What are some causative factors for the type of anemia the client has? * Bleeding: if the bleeding is excessive or occurs over a period of the time (chronic), the body may not take in enough iron or have enough stored to produce enough hemoglobin and/or red blood cells to replace what is lost. In women, iron deficiency may be due to heavy
The WBC and platelets are high because the Pt.’s body is trying to fight an infection.
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?
Exercise 11: Blood Analysis: Activity 1: Hematocrit Determination Lab Report Pre-lab Quiz Results You scored 75% by answering 3 out of 4 questions correctly. 1. Hematocrit Your answer : a. refers to the percentage of white blood cells (WBCs) in a sample of whole blood. Correct answer: b. of 40 means that 40% of the volume of blood consists of RBCs. 2. A buffy coat layer You correctly answered: d. is all of the above. 3. The diagnosis of anemia indicates You correctly answered: a. a lower-than-normal hematocrit. 4. Polycythemia refers to You correctly answered: c. a significant increase in RBCs.
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).
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.
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
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
As the concentration of hemoglobin in the Red Blood Cells falls below normal, the total Red Blood Cell count consequently decreases. Therefore, oxygen cannot be adequately carried. (http://www.mayohealth.org/mayo/pted/htm/iron.htm).
If you feel down and scraped your knee, describe what each type of blood cell would be doing at the site of injury
Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what they need to function properly, according to the article, "Anemia Causes, Types, Symptoms, Diet, and Treatment." During the civil war more than 150 prisons were established where around 400,000 men had been imprisoned.
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.
In 1910 Dr. James B. Herrick published a paper identifying an abnormal shape of RBCs. He took care of a young dental student by the name of Walter Clement Noel; he was admitted into the hospital for episodes of pain and anemia like symptoms. Samples of his blood were
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
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).
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.