Laboratory values

In a short essay (500-750 words), answer the Question at the end of Case Study 1. Cite references to support your positions.

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NRS410V.R.CaseStudy1_Student_02-11-13.docx

RUBRIC GRADING

1. Accurate identification of anemia classification and rationale.- Identification of anemia classification and rationale is offered in detail, while demonstrating evidence of deeper insight and/or reflection.

2, Explanation of patient diagnosis with rationale from case findings. Outside sources and/or medical and nursing references used to support conclusions.- Explanation of patient diagnosis uses outside sources and/or medical and nursing references to support conclusions and is offered in detail, while demonstrating evidence of deeper insight and/or reflection.

3, Thesis Development and Purpose- Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

4, Paragraph Development and Transitions- There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

5, Mechanics of Writing (includes spelling, punctuation, grammar, language use)- Writer is clearly in command of standard, written, academic English.

6, Paper Format (1- inch margins;12-point-font;double-spaced;Times New Roman, Arial, or Courier)- All format elements are correct.

7, Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)- In-text citations and a reference page are complete. The documentation of cited sources is free of error.

Case Study 1

Case Study 1

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increased shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament at a high, mountainous course, she became light-headed and was taken by her golfing partner to the emergency clinic. The attending physicians notes indicated a temperature of 98 degrees F, an elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, Menorrhagia and dysmenorrheal have been a problem for 10-12 years, and I take 1,000 mg of aspirin every 3 to 4 hours for 6 days during menstruation. During the summer months, while playing golf, she also takes aspirin to avoid stiffness in my joints.

Laboratory values are as follows:

Hemoglobin = 8 g/dl

Hematocrit = 32%

Erythrocyte count = 3.1 x 10/mm

RBC smear showed microcytic and hypochromic cells

Reticulocyte count = 1.5%

Other laboratory values were within normal limits.

Question

Considering the circumstances and the preliminary workup, what type of anemia does Ms. A most likely have? In an essay of 500-750 words, explain your answer and include rationale.

Anemia Case Study

                Ms. A is most likely suffering from a kind of Anemia that is referred to as Iron Deficiency Anemia. Weekend warriors that train for less than four hours in a week have no issue with Iron Deficiency Anemia. On the other hand, for endurance performers including Ms. A, a golfer, there is high vulnerability to the disease. This is based on the fact that it is difficult to balance the incurred losses and iron absorption considering the demanding training (Schurman, 2014). Mountaineers who participate in aerobics for above six hours every week have higher chances of suffering from Iron Deficiency Anemia. This is in addition to active women in their childbearing age and who undergo through immense energy lack during heavy menstrual flows, and pregnant and nursing women. Principally, women with chronic anemia are asymptomatic even in cases where there is abnormally low hemoglobin levels (Schurman, 2014). Athletes that engage in sports emphasizing on lean physiques normally have insufficient dietary iron intake, similar to sport climbing. Usually, healthy women with reserved iron deficiency that is adequately mild to the extent where there are typically no anemia signs often get minimal benefits following aerobic exercise compares to those with normal iron levels. Hence, these women tire earlier compared to normal exercise case. In fact, no improvements are experienced even with sufficient rest, exercise, and proper nutrition. In these cases, a serum ferritin test or Complete Blood Count is essential (Schurman, 2014).

            Iron deficiency anemia results from low red blood cell count or low levels of hemoglobin as a result of too minimal iron in the body. This is usually the case when there is more iron loss than intake. Iron makes a significant part of the hemoglobin, a molecule of the red blood cells that transports oxygen to the cells in the whole body. In cases where the body has no adequate iron stores, less hemoglobin is manufactured for filling the red blood cells. As a result, the size and number of the red blood cells reduce (Schurman, 2014). The body’s ability to transport oxygen to the tissues is therefore cut down, which leads to extreme fatigue even without strenuous activities.

            The US statistics have established that more than 80% of female athletes have signs of Iron Deficiency Anemia. There is a two-fold likelihood that women will be anemic. In every 10 pre-menopausal, one is anemic. In this regard, it is recommendable to have anemia tested regularly. Ms. A also portrays other symptoms associated with the disease such as dizziness, lightheadedness, fatigue, shortness of breath, weakness, lack of endurance during exercise, as well as rapid heartbeat (Schurman, 2014).

            Dramatically, Iron Deficiency Anemia compounds the effects of altitude. In addition, it escalates the risks associated with altitude sickness if left untreated. Hence, it is highly recommendable to be cautious as severe anemia results in high-output heart failure that is extremely life threatening especially if mountains emergency rescue missions are not available.

            Usually, women experience heavy menstrual bleeding at a certain stage in life. In the case study, the woman experiences a menstrual flow for six days and this might be one of the causes of her condition. Many women experience a flow of four to five days and as a result, about 4 tablespoons to one cup of blood gets lost. Basically, a tablespoon is equal to 15ml of blood and an ml is 0.5 mg of iron (Schurman, 2014).  Her symptoms get worse during the menstrual flow and she has been having menorrhagia for some years.

Reference

Schurman, C. (2014). Iron Deficiency Anemia: Symptoms and Solutions.

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