HOMEWORK GUIDE | In clinical settings, patients often present with many different types of anemia.

In clinical settings, patients often present with many different types of anemia. Each type of anemia has its own causes and implications. For this reason, you must be able to differentiate between types of anemia as well as identify factors that put patients at greater risk of experiencing related complications. As you prepare for this Discussion, consider the following patient case studies:

Case Study 2

A 28-year old female presents for a routine physical. She has no complaints. Her personal medical history reveals asthma that is well controlled with an albuterol inhaler prn and Advair 250/50 1 puff BID. Social history reveals she is a nursing student who is a non-smoker, rarely uses alcohol, and is mostly vegetarian. Her physical exam is negative, and she is sent for a CBC/differential and lipid profile. Laboratory results reveal the following: Hemoglobin 10, Hematocrit 30.1, MCV increased.

To prepare:

• Review Chapter 237 in Part 21 of the Buttaro et al. text.
• Select one of the three case studies. Reflect on the provided patient information including history, physical exams, and lab reports.
• Think about a differential diagnosis. Consider the role the patient history, physical exam, and lab reports played in the diagnosis.
• Reflect on the pathophysiology of the type of anemia that you diagnosed, as well as potential treatment options. Consider the causes of this type of anemia. Think about whether the patient should be referred for specialized care.

Please include this format

treatment plan outline and will require and grade your work using THIS format:

Specific exam(s):

Screening tools:

Tests, cultures, lab work:

Prescriptions(s):

Interventions/ lifestyle changes

Referrals:

Follow up:

Education:

MODEL ANSWER

            The 28-year old female patient in the case selected is suffering from Macrocytic anemia. This is type of anemia where the body produces few but normal size red blood cells. The red blood cells produced have mean corpuscular volume (MCV) of greater than 100 femtolitres, a situation called macrocytosis (Johnson-Wimbley & Graham, 2011). There are two different forms of macrocytic anemia, which include megaloblastic macrocytic anemia and nonmegaloblastic macrocytic anemia. The first type, Megaloblastic macrocytic anemia, usually result from deficient in folate and vitamin B12 (Stabler, 2013). On the other hand, Nonmegaloblastic macrocytic anemia result from hypothyroidism, alcoholism, and liver disease. Symptoms include fatigue, pale skin, loss of weight, shortness of breath, brittle nails, tachycardia, loss of appetite, diarrhea, poor concentration, or memory loss.

Role of Patient History, Physical Exam, and Lab Reports

            Patient history and physical assessment are critical to every patient. However, Macrocytic anemia may not be properly diagnosed because some patients may be | PLACE YOUR ORDER NOW AT writtask.com | 28-year old female patient presents to the clinic for a routine physical and has no complaints. However, the patient is a vegetarian, a situation that increases her risk for anemia due to iron | PLACE YOUR ORDER NOW AT writtask.com | results are critical in making a differential diagnosis. The results showed a low hematocrit (Hct), hemoglobin (Hb), and a high (MCV), which is an indication of presence of macrocytic anemia.

Pathophysiology and Treatment

            Megaloblastic anemia is the primary cause of macrocytic anemia, which result from impaired DNA synthesis. In this case, RNA synthesis is normal while the DNA synthesis is impaired, a situation that lead to the buildup of cytoplasmic elements in a gradually dividing | PLACE YOUR ORDER NOW AT writtask.com | than normal cells are produced (Lam, 2017). Treatment is based on the type of macrocytic anemia. Therefore, additional lab tests are fundamental to assess the type of macrocytic anemia the patient is | PLACE YOUR ORDER NOW AT writtask.com | megaloblastic macrocytic anemia, there will be a need to correct her vitamin deficiency. In this case, treatment would include prescribing for oral supplements of vitamin B and folate or vitamin B-12 injections. Diet modifications will also be recommended…