Question

I. Read Chapters 29 and 30 from your Textbook and PP presentations

II. NCLEX Review Questions Chapters 29 and 30 from Evolve Resources

III. Anemia

Patient Profile

D.G., a 72-year-old male whose wife died six months ago, is brought to the health care provider by his daughter because he is not eating much and has been lethargic and sleeping a lot. He has a history of hyperlipidemia for which he takes niacin/lovastatin 500/20 mg PO daily at bedtime.

Subjective Data

Has been unusually tired for the past couple of months

Is frequently short of breath and sometimes feels like his “heart is pounding”

Has lost weight because his wife always used to cook for him and he doesn’t cook for himself

Describes a typical daily meal as coffee and a donut for breakfast, a hot dog and lemonade for lunch, and a jelly sandwich on white bread and coffee for supper

Objective Data

Physical Examination

Blood pressure 118/72, pulse 98, temperature 98.2° F, respirations 16

Oxygen saturation 92% on room air

Height 5’6”, weight 135 lbs, BMI 21.7 kg/m²

S1 and S2 auscultated and regular

Bilateral radial pulses +3 and regular

Lungs clear bilaterally

Diagnostic Studies

RBC                      3,300,000/µL

Hemoglobin       8.3 g/dL

Hematocrit         24%

MCV                    73 fL

MCH                    23 pg

WBC                    9,100/µL

Platelets             250,000/µL

Iron                     28 mcg/dL

Ferritin                14 ng/mL

Cobalamin         600 pg/mL

Folate                  10 ng/mL           

Discussion Questions

1. nterpret D.G.’s laboratory results.

2.What are important points to include when teaching patients taking oral iron supplements?

Answer 1

1.interpreting the lab results;

RBC is low(normal is 4.2-5.5 million /microlitre

Hb is low(normal is 12.5-16g/dl

Hematocrit is low(normal is 35-53%)

MCH is low(normal is 26-33pg)

Iron is low(normal is 35-50 mcg/dl)

Ferritin is low

From the above lab results,the patient is having anemia,probably iron deficiency anemia.

2.

*Number of pills that should be taken and when it should be taken(taking more than prescribed cause serious medical conditions)

*May suffer from cramps,nausea and diarrhoea if taking iron supplements.taking the drug with small amount of food will decrease the symptoms.

*Milk ,calcium supplements,antacids should not be taken together with it.(reduces absorption of iron).If they are taken,wait for atleast 2 hrs after having these foods ,before taking iron supplements.

*Take iron supplements along with orange juice,lemon juice etc(increases the absorption of iron)

*Black stools are common with iron supplements intake.

*Liquid form may cause staining on teeth ,so use a straw or mix it with liquids.