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UT Arlington NURS 5315 - Anemia and the Body

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1Anemia and the BodyJames NeighborsDepartment of Graduate Nursing, The University of Texas at ArlingtonCollege of Nursing and Health Innovation NURS 5315: Advanced Pathophysiology John D. Gonzalez, DNP, APRN, ACNP-BC, ANP-CJune, 13, 20201. The clinical scenario is most consistent with which diagnosis? The most likely diagnosis is that the patient has Iron Deficiency Anemia (IDA) 2. What data in the clinical scenario supports your diagnosis?a. The patient has a (low) mean corpuscular volume, normal range is 80-96 femtoliters per cell and this patient has a value of 70 fL.2b. (Low) Hemoglobin for male, normal range is 13.5-17.5 g/dl and this patienthas a level of 7 g/dlc. (Low) Hematocrit, normal range for a male is 41-50% and this patient has a level of 21%d. (High) TIBC, normal range is 240-450 mcg/dl and this patient has a level of 520 mcg/dle. (Low) Serum Iron, normal range is 60-170 mcg/dl and this patient has a level of 55 mcg/dlf. (Low) Ferritin levels, normal range is 12-300 ng/ml for males and this patient has a level of 10 ng/ml3. What is the most likely cause of this patient’s anemia? a. Frequent use of high dose 800mg of NSAIDs b. High dose/ frequent use of NSAIDs in combination with GERDc. High dose/ frequent dose resulted in possible peptic ulcer disease 4. Describe the key pathophysiological concepts of the diagnosis in question a. 1) What is the electron transport chain and how is it altered by anemia? The electron transport chain is a series of electronegative molecules that transfer electrons through reactions called redox (Huether, 2019). Hydrogen ions are paired in the redox reaction and cross the inner mitochondrial membrane (Huether, 2019). When this process is occurring the electrochemical gradient is being formed (Huether, 2019). The electrochemical gradient allows for ATP to occur and be produced for use (Huether, 2019). O2 is the leading power source for this process to occur (Huether, 2019). Poor O2 levels will cause the patient to have decreased levels and functioning of the electron transport chain, resulting in inadequate ATP production (Huether, 2019). b. 2) Why is the iron level 55 mcg/dL? Peptic Ulcer Disease (PUD) disallows/slows the absorption of iron (Huether, 2019). Iron is brought through the bloodstream and sent to the small intestines for absorption viaintake of consumed foods that are iron containing (Huether, 2019). Bleeds from PUD can cause the amount of iron absorbed to decrease due to the loss from bleeds resulting in lower iron levels (Huether, 2019). c. 3) What effects does anemia/low blood volume have on the cardiovascularsystem? When the body has low iron levels and consequently low blood volumes the heart increases rate and contraction force to compensate for the loss (Huether, 2019). This is the body's means of protecting itself. The RAAS will also be activated in this process (Huether, 2019). d. 4) What are the effects of tissue hypoxia on the cardiovascular system, pulmonary system and CNS? Angina, which this patient has, is a result of ischemia of the cardiac myocytes (Huether, 2019). The patient complains of dyspnea on excretion (DOE), this occurs when the pulmonary system attempts to compensate for lower oxygen levels in the body (Huether, 2019). The irritability of the CNS is a direct result of the patients reduced oxygen levels or hypoxia (Huether, 2019). 5. What risk factors does this patient have which warrants referral for additional diagnostic screening testing?3a. Patient has family history of colon cancerb. Patient has an associated risk due to agec. Patient needs a colonoscopy if it hasn't been completedd. Patient should speak to primary physician and consider referral for EGD, which will rule out PUD or confirme. Patient needs to evaluate the medicine regime. High doses of NSAIDs aredamaging to the body over long periods of time.4ReferencesHuether, S. E., (2019). The cellular environment. In K.L. McCance & S.E. Huether (Eds.), Pathophysiology: The biologic basis for disease in adults and children (8th ed., pp.104-134). Mosby


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