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Clinical Scenario:International Journal Of Science And Research

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Question:

Discuss about the Clinical Scenario for International Journal of Science and Research.

 

Answer:

Menorrhagia- This is when there is a prolonged heavy bleeding that occurs during the normal menstrual cycle of a woman.

Causes-hormonal imbalances ("Iron Deficiency Anemia (IDA): A Review", 2016)

    1. Anemia- This is a condition where a person has a lowernumber of red blood cells or level of hemoglobin than normal (Townsend, Cheung, Horne & Ransford, 2016)
    2. Iron deficiency anemia- This is due to the fact that the will try to make more red blood cells and hemoglobin using the iron stored in the body hence leading to iron deficiency("Iron Deficiency Anemia (IDA): A Review", 2016).
    3. The reason for tiredness and shortnessof breath is due to the fact that Fiona has no enough red blood cells to carry oxygen around the body. Oxygen is required for metabolisms and production of energy in the body(Auerbach & Adamson, 2015).
    4. Petechiae arered or purple spots on the skin that are usually as a result of bleeding into the skin. Fiona has a type of anemia that contains fewer platelets hence the bruising (Townsend, Cheung, Horne & Ransford, 2016). This is due to the fact that her blood does not contain iron-rich proteins thus the level of hemoglobin and platelets should be tested to determine the coagulation process. Another disease process such as anaphylaxis should also be tested(Auerbach & Adamson, 2015).
    5. Complete blood count and hemoglobin level. Normal hemoglobin level ranges between  13 to 18 in men and 12 to 16 in women grams per deciliter("Iron Deficiency Anemia (IDA): A Review", 2016).
    6. Increase heart rate and respiration rates are due to the fact that there is low oxygen concentration in the body due to less hemoglobin. The body responds to an extent that more respiration isneeded to increase oxygen intake and more heart rates to distribute the little oxygen available to all parts of the body(Auerbach & Adamson, 2015).
    7. Excessive glucose can damage the nerves that send a signalto kidney hormones which trigger production of red blood cells (Townsend, Cheung, Horne & Ransford, 2016).
    8. Leukemia is a malignant of blood stem cells including the bone marrow and the lymphatic system("Iron Deficiency Anemia (IDA): A Review", 2016).
      1. Hodgkin disease is cancer of the lymphocytes. Hodgkin’s lymphoma usually has reed Sternberg cells but nonHodgkin does not have when examined under a microscope(Auerbach & Adamson, 2015).
    9. Multiple myelomasis type of cancer that forms in plasma cells of the white blood cells. 
 
  1. Thrombocytopenia is a condition where the body has low platelet count. This can cause severe internal bleeding especially when the protein count isbelow 10, 000 platelets per microliter. (Auerbach & Adamson, 2015)

Nursing diagnosis /problem  

Goals

Interventions

Fatigue related to decreased

 Hemoglobin levels as evidenced by patients complain of feeling tired and having short of breaths

The client will verbalize that she have a reduced fatigue and report increased energy and desire to go to the gym

1. Monitor hemoglobin and blood cells levels

2. Instruct patient about medication that might stimulate red blood cell production

Impaired skin integrity related to broken skin capillaries as evidenced by the presence of bruises.

The patient will demonstrate reduced bruises in a period of one day

1. Educate Fiona on the best nutrition, hydration, and methods to maintain tissue integrity

2. Provide tissue care as needed

 

 

 

Ineffective tissue perfusion related to low hemoglobin levels as evidenced by increases respiration rates up to 22 beats per minute

The patient will demonstrate effective tissue perfusion and able to breathe normally

1. Provide with oxygen therapy

2. Transfuse blood to increase hemoglobin levels.

(Auerbach & Adamson, 2015)

  1. Anaphylaxis is a rapid severe allergic reaction that affects several body systems due to the release of cytokines and inflammatory mediators from basophils and due to an immunologic reaction. The immunoglobulin E binds to antigen activating the receptors of basophils and mast cells. This leads to the release of histamines which increases leakage of fluids from capillaries, contraction of bronchial smooth muscles and triggers vasodilation (Mayo Clinic 2018).
  2. Antihistamines through intravenous injection.
  3. C
  4. D
  5. B
  6. E
  7. C
  8. D
  9. C
  10. B
  11. B
  12. E  
 

References

Auerbach, M., & Adamson, J. (2015). How we diagnose and treat iron deficiency anemia. American Journal Of Hematology, 91(1), 31-38.

Mayo Clinic (2018)Anaphylaxis - Diagnosis and treatment - Mayo Clinic. Retrieved  from  https://www.mayoclinic.org/diseases-conditons/anaphylaxis/diagnosis-treatment/drc-

Iron Deficiency Anemia (IDA): A Review. (2016). International Journal Of Science And  Research (IJSR), 5(4), 1999-2003.

Townsend, S., Cheung, D., Horne, E., & Ransford, R. (2016). A 5-Year Follow-Up of Study Patients With Asymptomatic Iron-Deficiency Anemia Using a Nurse-Led

Pathway. Gastroenterology Nursing, 39(6), 466-471.

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