NUR 502 Week 2 Hematopoietic Factors Iron Deficiency Discussion St Thomas University

Identify the factors contributing to J.D.’s risk of developing iron deficiency anemia.

Various factors in J.D.’s patient history indicate a susceptibility to iron deficiency anemia. Notably, the patient underwent four pregnancies within a four-year span, potentially leading to significant blood loss during childbirth (Garzon et al., 2020). Additionally, experiencing six days of intense menstrual pain and heavy bleeding, surpassing the usual amount, may expose the patient to anemia. Lastly, the report of intermenstrual bleeding over the past two months suggests the presence of menorrhagia, characterized by menstrual blood lasting more than seven days. Cumulatively, these elements contribute to substantial blood loss, placing the patient at risk for anemia.

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Alcohol Use Disorder Rachel Adler shadow health Documentation/Electronic Health Record

Discuss the reasons behind J.D.’s presentation of constipation and dehydration in the case study.

The anemia resulting from blood loss may significantly contribute to the patient’s symptoms of dehydration. Fluctuations in hormone levels, particularly estrogen and progesterone, induced by anemia, can lead to constipation and dehydration (Igbinosa et al., 2022). Hormonal influences may affect dehydration levels, causing variations that induce thirst and dizziness. Therefore, the primary causes of the patient’s dehydration and constipation are likely hormonal changes triggered by bleeding.

Examine the importance of Vitamin B12 and folic acid in erythropoiesis. Describe the abnormalities that may arise in red blood cells due to their deficiency.

Erythropoiesis, the process of generating new erythrocytes, relies on essential elements such as iron, folate, and vitamin B12 (Takahashi, 2022). Deficiencies in either folate or vitamin B12 hinder the proper function of purine and thymidylate synthases, impeding the proliferation of erythroblasts during differentiation. This leads to erythroblast death, impaired DNA synthesis, and anemia due to inefficient erythropoiesis. Adequate levels of iron are crucial for the proper functioning of erythroblasts and the synthesis of hemoglobin. Inadequate amounts of vitamin B12 and folate can result in significant abnormalities in red blood cells, including a smaller-than-usual size and a pale coloration.

The gynecologist is considering the possibility that J.D. is experiencing iron deficiency anemia. To support this diagnosis, let’s list and describe the clinical symptoms that J.D. might exhibit, indicating iron deficiency anemia.

As iron deficiency anemia progresses, clinical signs may become apparent, including pronounced fatigue, a pale complexion, weakness, cold extremities, chest discomfort, rapid heartbeat, and shortness of breath. Additionally, individuals with this type of anemia might develop unusual cravings, such as a desire for ice, dirt, or starch (Garzon et al., 2020). These symptoms align with the patient’s reported experiences, suggesting a potential diagnosis of iron deficiency anemia. The primary cause of anemia in such cases is a reduction in iron supply from heme synthesis, affecting the ability of erythroid cells to produce hemoglobin. Consequently, diminished hemoglobinization results in the production of smaller-than-usual (microcytic) erythrocytes with fewer hemoglobin molecules (hypochromic). In this specific case, the significant blood loss attributed to 6 days of heavy flow and intermenstrual bleeding is the leading cause of iron deficiency anemia.

If the patient is indeed diagnosed with iron deficiency anemia, certain signs are expected. The main indicators include unusual fatigue or exhaustion due to reduced oxygen-carrying capacity of hemoglobin. Paleness, resulting from lower hemoglobin levels, and shortness of breath, a consequence of diminished oxygen availability, are also typical. Individuals with this type of anemia may experience headaches, lightheadedness, and dizziness due to inadequate oxygen reaching brain cells. Heart palpitations may occur as the heart attempts to compensate for increased blood oxygen demand. These symptoms collectively characterize iron deficiency anemia.

Upon receiving the lab results for J.D. (Hb 10.2 g/dL, Hct 30.8%, Ferritin 9 ng/dL, and smaller, paler red blood cells), confirming iron deficiency anemia, appropriate recommendations and treatments can be considered.

With an Hb level of 10.2 g/dL, below the typical threshold of 13.5 g/dL, and Hct at 30.8%, within the usual range of 36%–44% for women, alongside a Ferritin level of 9 ng/dL (below the recommended Ferritin of 10 ng/dL), the diagnosis of iron deficiency anemia is substantiated (James, 2021; Miller, 2013).

For treatment, dietary adjustments are recommended to include iron-rich foods like green leafy vegetables, meat, legumes, fish, and iron-enriched cereals and pasta. Additionally, daily multivitamin supplements containing 150–200 mg of elemental iron are suggested, although potential serious side effects should be communicated to the patient (Igbinosa et al., 2022). In severe cases, intravenous iron may be administered for individuals with significant iron deficiency, persistent blood loss, or gastrointestinal issues hindering iron absorption. Those with severe anemia might require blood transfusions, especially if experiencing symptoms like weakness or chest discomfort.