Case Study Analysis (Anemia and CHF)
Case Study 1 (Anemia)
In the contemporary medical world, various classes of anemia are existent that one ought to be conversant with if they are to manage them effectively. Informing the classification of anemia are the different etiological factors that are contributing to this condition. Befitting examples of such etiological factors include decreased production of the red blood cells (RBCs), increased destruction of RBCs and increased blood loss. Based on this classification, the common types of anemia are iron deficiency, sickle cell, and hemorrhagic anemia respectively. A case in point of an individual presenting with clinical manifestations of anemia is evident in the scenario involving a 26-year-old female, Ms. A. In essence, an analysis of this case study to its practical details is the central idea of this discussion. At the heart of the study is the identification of the most likely type of anemia experienced by Ms. A.
Going by the clinical presentation of Ms. A, it is beyond doubt that she is suffering from the iron-deficiency anemia. Such is the case given that she presents with microcytic and hypochromic erythrocytes, which are classic features of the iron-deficiency anemia. According to Hinkle, Brunner, Cheever, and Suddarth, (2014), microcytic and hypochromic erythrocytes are common in three types of anemia, namely, sideroblastic, thalassemia and iron deficiency anemia. The latter is the suitable one in Ms. A’s case because of other reasons in her clinical presentation that point to this conclusion.
Notwithstanding, the excessive blood loss experienced by Ms. A also reflects the suitability of the diagnosis of iron-deficiency anemia. In as much that the circumstances of such a situation point to anemia secondary to excess blood loss, there is no denying that she is a victim anemia of iron-deficiency anemia. That is for sure because increased blood loss, particularly through the gastrointestinal tract, will result in the reduction of absorbed iron from the gut into the blood. As such, there is a deficiency in the iron content in the blood for binding with the heme. Consequently, the lack of sufficient iron reserves predisposes the individual to the iron-deficiency anemia (Copstead-Kirkhorn, & Banasik, 2014). Going by this explanation, Ms. A is thus subject to this fate since her menorrhagia and chronic use of the Aspirin predisposes her to the development of peptic ulcer disease, which leads to increased blood loss and reduced iron reserves. Clearly, with such a loss of blood, it is beyond doubt that iron-deficiency anemia will develop.
Furthermore, the laboratory values of Ms. A’s body parameters are also indicative of the diagnosis of iron-deficiency anemia. That is for sure since her hemoglobin (8g/dl), hematocrit (32%) and erythrocyte count (3.1×10/mm) are below the recommended values, which are 12-16g/dl, 36-48% and 3.8–5.8 X 1012 /L respectively (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2013). All these values are reminiscent of an individual with the diagnosis of iron-deficiency anemia.
In closure, this paper aimed at analyzing a case scenario involving Ms. A., 26-year-old woman presenting with classic signs of anemia. Without a doubt, this discussion has achieved this objective. Implication for nursing practice drawn from this analysis is the need for understanding the various types of anemia to their practical details. Such a comprehension is of utmost importance to the effective management of anemic individuals such as Ms. A. As such, going into the future, nurses need to take an active role in the updating of their knowledge of this medical condition if the situation is to change for the better. In the absence of such strategies, it is beyond doubt that management of anemic patients will remain problematic for the unforeseeable future.
References
Buttaro, T., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, Mo.: Elsevier Health Sciences.
Copstead-Kirkhorn, L., & Banasik, J. L., (2014). Pathophysiology (5th ed.).
Hinkle, J. L., Brunner, L. S., Cheever, K. H., & Suddarth, D. S. (2014). Brunner & Suddarth’s textbook of medical-surgical nursing.
Case Study 2 (CHF)
Currently, in the world of medicine, dealing with geriatric patients is the one of the most demanding task. That is for sure given high incidences of non-adherence to drugs and other instituted management strategies such as nutrition restrictions. A befitting example of an individual that exemplifies this assertion is Mr. P is a 76-year-old male with cardiomyopathy and congestive heart failure evident in a case study. In essence, this discussion focuses on analyzing Mr. P’s case scenario. Central to the analysis are issues such as the appropriate approach to care, treatment plan, a method of providing both patient and family education and teaching plan for Mr. P.
Approach to Care
Primarily, the plan of care that one adopts with elderly persons such as Mr. P is of utmost significance to their effective management. That is for sure because the approach will determine how the likes of Mr. P will respond to the instituted plans of treatment. That said, central to the approach of care adopted for Mr. P’s case is the home-based care approach. In this method, a healthcare professional meets the needs of the patient at the comfort of his/her home environment except for complicated conditions that necessitate referral to the hospital setup. Holistic care and patient-centered care are among the many principles that inform home-based care, and both reflect the suitability of this approach in Mr. P.’s case. That is for sure since Mr. P presents with physical, psychological, social and emotional needs, which nurses can only address if holistic and patient-centered care is at the core of the adopted management strategies (Hayashi, Leff, DeCherrie, & Soriano, 2016). Clearly, this is proof enough for the suitability of the home-based care approach for Mr. P’s case.
Treatment Plan
Central to the management of Mr. P are pharmacological agents that have the capacity of relieving his CHF symptoms. However, caution is necessary for the use of these agents because Mr. P.’s advanced age endangers him to developing adverse drug reaction secondary to the aging changes in the body. A case in point of a class of medications that is necessary for management of Mr. P.’s condition is the ACE inhibitors such as Enalapril (5-40mg/day). The mechanism of action of Enalapril is interfering with the Renin-Angiotensin-Aldosterone System (RAAS) by inhibiting the functioning of Angiotensin Converting Enzyme causing a reduction of the cardiac workload. Another drug for Mr. P.’s condition is a diuretic such as furosemide (Lasix) for the relief of the edema by precipitating diuresis (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2013).
Method for both Patient and Family Education
Going by the case scenario’s depiction of both Mr. P and his wife, it is apparent that there is a need for education for both parties. The success of the patient and family education session is dependent on the adopted teaching delivery method. For Mr. P and his wife, the teach-back method would be the most appropriate for the education session. That is the case because the teach-back method allows the nurse to assess both the patient’s and family’s level of understanding after a completed teaching session and the need for further teaching (Mattu, Grossman, & Rosen, 2016). In this case, this method is significant since it will allow the nurse to establish the Mr. P.’s and his wife’s comprehension of the instructions for his care while at home. Consequently, the nurse will have an idea on whether or not to reinforce the health messages.
Teaching Plan
At the heart of the success of managing Mr. P’s condition is a teaching plan that will address the learning needs of this patient and the wife. The lesson plan entails various elements that are worth noting. A case in point is medication adherence, in which a nurse must inform the patient of the need to comply with the treatment regimen to the latter. Without such compliance, the CHF symptoms are likely to recur (Burton, & Ludwig, 2014).
Secondly, the nurse must also reinforce the need for Mr. P. to adopt a cardiac diet, which comprises of foods low in sodium and fats. Such a diet reduces the worsening of the CHF symptoms (Burton, & Ludwig, 2014).
Notwithstanding, the teaching plan for Mr. P. will also prioritize on the fluid restriction. Such a topic is vital since increased fluid consumption increases the preload and cardiac workload causing worsening of the heart failure (Burton, & Ludwig, 2014).
Conclusion
Concisely, this paper aimed at carrying an in-depth analysis of Mr. P’s case scenario. Precisely, it has achieved this objective by establishing the Mr. P.’s appropriate approach to care, treatment plan, a method of providing both patient and family education and teaching plan. Based on this analysis, it is apparent that elderly patients like Mr. P are in dire need of support and extra attention given their present deficiencies in old age. As such, going forward, measures to strengthen support for the elderly persons are of the essence if their healthcare experiences are to improve significantly.
References
Burton, M., & Ludwig, L. J. M. (2014). Fundamentals of nursing care: Concepts, connections & skills.Philadelphia, PA: F.A. Davis Company
Buttaro, T., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, Mo.: Elsevier Health Sciences.
Hayashi, J. L., Leff, B., DeCherrie, L., & Soriano, T. A. (2016). Geriatric home-based medical care: Principles and practice.Cham: Springer
Mattu, A., Grossman, S. A., & Rosen, P. (2016). Geriatric emergencies: A discussion-based review. Chichester, West Sussex, UK ; Hoboken, NJ, USA : John Wiley & Sons Inc.
