Question

CASE SCENARIO: ANEMIA

History of Present Illness

Patient A's main grumbling is of feeling drained and winded on occasion. She likewise grumbles of ligament undeniable irritations and hands. Audit of frameworks is striking for hearing misfortune, false teeth, glasses, and dyspnea, generally with effort. She has intermittent palpitations of the heart and orthopnea on occasion. Her solid discharges are normal, and she has not seen any blood in the stool. She has 1+ constant edema of the legs, which is about common for her.

Past Medical History

Her clinical history is positive for congestive cardiovascular breakdown, constant obstructive aspiratory sickness (COPD), persistent kidney infection, and osteoarthritis. During her last hospitalization, one year prior for pneumonia, the nephrologist and pulmonologist disclosed to Patient A there was very little else that should be possible for her. In spite of the helpless anticipation, her numerous ailments settled and she finished a restoration program. She appreciates partaking in exercises and has created fellowships with some different inhabitants. Over the previous year, she has been treated for different contaminations, including bronchitis and numerous urinary lot diseases.

Questions:

1. Conceptualize the pathophysiological alterations distinct to the case.
2. Make at least two nursing care plan based on your assessment that needs to prioritize.

Answer 1

Anaemia is not a single disease but a group of disorders in which Hb concentration of blood is below the normal range for the age and sex of the subject.

Anaemic hypoxia results due to decreased O2 carrying capacity of blood in anaemia owing to reduced Hb concen-
tration. The hypoxia brings about several cardiorespiratory compensatory responses.

The clinical manifestations of anemia vary with age, rapidity of onset, and concurrent clinical conditions. The tissue hypoxia that results from decreased oxygen-carrying capacity is responsible for the clinical signs and symptoms, which include fatigue, shortness of breath, altered menses, and pallor of skin and mucous membranes; potentially more serious manifestations include tachycardias, congestive heart failure, and icterus

PATHOPHYSIOLOGICAL ALTERATIONS

General clinical manifestations of anaemia which occur either due to tissue hypoxia or due to compensatory mech-
anisms are:
Generalized muscular weakness, tiredness and easy fatiguability occur due to muscle hypoxia.

Pallorness of skin and mucous membranes (buccal and pharyngeal mucous membrane, conjunctiva, lips, ear
lobes, palm and nail bed) occurs due to the deficiency of red coloured Hb in the blood.

Respiratory symptoms such as breathlessness with increased rate and force of respiration occur due to
compensatory stimulation of respiratory centre.

Cardiovascular manifestations, such as palpitation ,tachycardia and cardiac murmurs occur as a result of compensatory mechanisms increasing the cardiac out-put.

In very severe cases of anaemia, features of cardiac failure, angina pectoris may also occur in an attempt to   restore tissue oxygenation.

Infections in anaemia are due to compromised immune system.

Edema in anaema  is an indication of generalsed vasodilation,due to reduced inhibition of basal endothelial derived relaxing factor

NURSING CARE PLAN

1. Assist the Patient in developing a schedule for daily activity and rest.
2. Stress the importance of frequent rest periods.
3. Monitor hemoglobin, hematocrit, RBC count, and reticulocyte counts.
4. Assess for local or systemic signs of infection, such as fever, chills, swelling, pain, and body malaise.
5. Monitor WBC count
6. Dietary advice