Question

D.G., a 72-year-old man whose wife died 6 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 lb, 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 9100/µL * Platelets 250,000/µL * Iron 28 mcg/dL * Ferritin 14 ng/mL * Cobalamin 600 pg/mL * Folate 10 ng/mL D.G. is diagnosed with iron-deficiency anemia

5. With D.G.’s loss of his wife who cooked meals for him, and based on his present living situation, what are a couple of ways or things that could be done to assists in his intaking of better rich ironed foods? List at least two:

6. The health care provider (HCP) has prescribed an iron supplement for D.G. What would

you teach D.G. about taking iron supplements? List at least four:

7. Evaluate D.G’s readiness to learn. What is one positive and one negative factor that might affect the chances of learning success?
   1. One positive factor:

2. One negative factor:

Reference(s):

Answer 1

Ways to assisst his in take of iron rich foods

1. Advice the person to take iron rich foods such as

• Lear red meat ( best source of easily absorbed heme iron)
• Advice the daughter to include chicken and fish in his meals.

2. Make a menu plan for D.G and give beacuse iron rich diets can treat the iron defeciancy anemia.

• Breakfast

Option 1

Iron fortified cereals and a glass of iron fortified orange juice

Option 2

A hand ful of pumkin

• Lunch

Option 1

A sandwich with roast beef

Option 2

A bagel with smoked salmon,cheese creams and spinach

• Dinner

Option 1

Lamb chops with boiled potatoes

Option 2

A stew that include kidney beans,chickpeas,black-eye peas,onion, red pepper and garlic.

Patient teaching about iron supplimentation

1. Educate him that he his suffering with iron deficiency anaemia so the iron supplimentation is the treatment of choice for the same.
2. Take the iron tablet in an empty stomach because iron absorption is reduced with food.iron suppliments can cause cramps,nausea and diarrhea in some people so if it is present you can take iron after a small amount of food.
3. Eat fiber rich foods to minimize the problem with contipation.
4. Remember that your stool will become dark in colour once you start to take the iron supplimentation.

D.Gs readiness to learn

Positive factor

He is verbalized his probles that has been usually tired for the past couple of months is freequently short of breath and some times feels like his heart is poundig. It is a positive sign that atleast he is concern about his health.

Negative factor

Here the main negative factor is his psychological status.Because he lost his wife 6 months ago,and he is 79 years old. Partner is the one and only companion during our old age.And that is the sign that D.G is not taking proper food after the death of his wife.Which means that he is not fine psychologically.This mind disturbance will affect his ability to learn.

References:-

1. www.healthline.com
2. www.medicalnewstoday.com
3. m.ufhealth.org