Background Year African Explained for Students (Easy Guide)

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Background Mia,15-year-old African American girl, is being seen for a 6 week follow up for a re-check of her hemoglobin after a packed red blood cell transfusion. She presents today with purple hemorrhagic spots on her skin. She reports to have been feeling tired for the last several weeks as well as shortness of breath and feeling generally achy. In addition, the patient complains of daily headaches, and a “jittery heart”. Her mother noticed that she has been looking pale as of late. Mia reports loss of appetite and darker than normal stools that often appear tarry. She continues to follow a vegan diet. She has been taking Ferrous Sulfate 325 mg daily which was prescribed to treat similar symptoms described at her previous visit. The diagnosis at that time was determined to be unspecified iron deficiency, based on iron studies and her history of heavy flow during her menstrual cycle. The patient had leukemia as a toddler but has been in remission for 12 years. Her mother reports that her own brother has a history of anemia. Today, her diagnosis has been updated to anemia. Her data is as follows: Clinical Profile Patient Data: Age: 15 Weight: 105lb Height: 5′ 4″ BMI: 18.0 Previous labs: CBC Lab Values: Hgb: 12.4 grams/dL Hematocrit: 37% WBC: 4,500 thousand cells/mcL RBC: 4.4 million Platelets: 150,000 thousand/mcL Serum Iron: 60 Physical Assessment: Pallor, slight swelling of both feet, sore tender gums with reports of frequent bleeding associated with brushing, petechiae noted on lower extremities Vitals: Heart rate: 116 beats/min Respiratory rate: 28 breaths/min Blood pressure: 102/52 mm Hg Oxygen saturation: 88% Temperature: 101.4 Pain: 4/10 Today’s Lab Values: CBC Labs: Hgb: 9.1 grams/dL Hematocrit: 29.3% WBC: 23,800 thousand cells/mcL RBC: 3.1 million cells/mcL Platelets: 68,000 thousand/mcL Serum Iron: 180 Current Medications: Etonogestrel daily Ferrous Sulfate 325mg po daily Mulitivitamin daily Identify 2 risk factors for anemia that Mia possesses. Identify at least 3 pieces of data (subjective or objective) related to Mia that the nurse knows is consistent with a diagnosis of anemia. Identify at least 3 pieces of data related to Mia that the nurse recognizes as abnormal, but not directly indicative of anemia. Explain the significance of Mia’s Vital Signs. What does each reading tell you, and if it’s abnormal, explain why it would be abnormal in her case. Explain the rationale for each of Mia’s medications. Why is she taking them? Despite starting Ferrous Sulfate at her last visit 6 weeks ago, Mia’s hemoglobin and RBC continues to decline. Looking at all of the data presented, explain why you think this is. Identify the normal for each of the following and what abnormal values (high and/or low) may indicate to the nurse. RBC- WBC- Platelets- Citations: Case Study Rubric

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