Respond to two peers Anemia discussion

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Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response.

#1.

Catherine Klink posted Aug 18, 2020 8:07

Week 6 Discussion Anemia

The three different types of anemia that we are looking at in this discussion are microcytic anemia, normocytic anemia, and macrocytic anemia. In microcytic anemia the erythrocytes (RBC’s) are small in size and therefore not able to bind as well to oxygen for transport throughout the body (Chaudhry et al, 2020). The most common form of microcytic anemia especially in females is iron deficiency anemia (IDA). This may be caused by a variety of conditions including not enough iron in the patient’s diet, blood loss, poor absorption of iron in the gastrointestinal tract, or the body’s increased demand for iron in different situations such as pregnancy or while recovering from trauma. A MCV size of below 80 femtolitre/RBC (fl/RBC) is seen in microcytic anemia. This type of anemia is treated by blood transfusions as well as addressing the reason that the patient is iron deficient, such as birth control for heavy periods or dietician consult for proper nutrition (Chaudhry et al, 2020).

Normocytic anemia is usually caused secondary to an inflammatory disease process (Nemeth, 2014). In this type of anemia, the patient has low serum iron levels even though the serum ferritin level is normal. This type of anemia rarely demonstrates a HGB less than 8. The ferritin level is usually less than 15 in patients that are experiencing normocytic anemia. This type of anemia is treated by treating the underlying disease process as well as infusing iron and blood as necessary (Nemeth, 2014).

In macrocytic anemia the RBC’s are enlarged with a MCV greater than 100 fl/RBC (Nagao et al., 2017). To treat macrocytic anemia the practitioner must differentiate if it is megaloblastic or nonmegaloblastic anemia. Megaloblastic anemia is caused by either a deficiency or an underutilization of vitamin B12 or folate, or both. Nonmegaloblastic anemia is secondary to other disease processes such as liver dysfunction, hypothyroidism, some drugs, chronic alcoholism, myelodysplastic syndrome, or inherited disorders that effect the synthesis of DNA. The treatment for this type of anemia is based upon the underlying cause of the anemia itself, so may vary greatly (Nagao et al., 2017).

This patient is suffering from microcytic anemia. This is evidenced by the decreased H&H as well as the low MCV value noted on her CBC. The next tests that would be done to definitively diagnose this anemia would include a TIBC and a ferratin level (Huether et al., 2019). If the practitioner is questioning the type of anemia that the patient is experiencing, they would also draw a B-12 level to rule out other types of anemia. Prior to drawing the CBC the practitioner should have obtained a complete history and physical including menstrual history that included length and severity of bleeding. After the diagnosis of IDA the practitioner should obtain a dietary history of the patient as well to help determine if this is one of the factors causing the anemia (Huether et al., 2019).

No matter what type of anemia the patient is experiencing the body will be suffering from a decreased oxygen level secondary to the hemoglobin molecule carrying less oxygen throughout the body (Huether et al., 2019). Whether this is from a decreased number of cells or a deformity of the cells themselves does not matter both cause a reduction in the amount of oxygen that is being distributed throughout the body. Some of the ways that the body may compensate for anemia includes increased cardiac output, redistribution of cardiac output, increased oxygen extraction, as well as changes to the oxygen-hemoglobin affinity.

References

Chaudhry, H., & Kasarla, M. (2020). Microcytic hypochromic anemia. In StatPearls. StatPearls Publishing.

Huether, S., & McCance, K. (2019). Pathophysiology the biologic basis for disease in adults and children (8th ed.). In V. L. Brashers, & N. S. Rote (EDS.), Elsevier.

Nagao, T., & Hirokawa, M. (2017). Diagnosis and treatment of macrocytic anemia in adults. Journal of general and family medicine, 18(5), 200-204. https://doi.org/10.1002/jgf2.31

Nemeth, E., & Ganz, T. (2014). Anemia of inflammation. Hematology Oncology Clinics of North America, 28(4), 671-681. https://doi.org/10.1016/j.hoc.2014.04.005

Reply to Thread

#2. Derender Bailey posted Aug 21, 2020 3:47

Anemia

Total iron-binding (TIBC), ferritin, and serum iron levels in iron studies constitute a set of blood tests to estimate and measure the elemental iron carried in the blood. This mineral is a vital component of hemoglobin, and thus its deficiency leads typically to anemia. The estimation of iron being taken in the blood total iron is given by serum iron level.TIBC helps in the storage of iron and aids in differentiating iron deficiency anemia. Ferritin is used to measure an individual’s iron level and also helps in determining whether there is excessive or inadequate iron in the blood. Vitamin, Folic acid, and B12 present in serum level obtained from a patient help diagnosing megaloblastic anemia. This anemia frequently occurs due to deficiency of folic acid and vitamin B12.the presence of erythropoietin levels in the blood influences the diagnosis of anemia. Less erythropoietin production from the kidney indicates dysfunction, hence the low blood count in some patients (Basavanthappa, 2011).

Microcytic Anemia

Morphology

Pale color, small size

MCH<27pg, MCV<80fl

Etiology

Copper deficiency, lead poisoning, thalassemia, deficiency of vitamin B6, and iron-deficiency anemia.

Normocytic anemia

Morphology

Color and normal size

MCH 27-34pg, MCV 80-100fl

Etiology

Hemolysis, acute blood loss, chronic disease, endocrine disorders, cell anemia, pregnancy, cancers, chronic kidney disease, and sideroblastic anemia.

Macrocytic Anemia

Morphology

Normal color, large size

MCH >34pg, MCV>100fl

Etiology

Folic acid deficiency, splenectomy, and cobalamin deficiency.

Laboratory results suggest that microcytic anemia is the utmost consistent with the selected lab results. An average corpuscular volume should be between 80-100 FL, but that is not the case for the chosen patient who has an MCV mean of 76fl. These results ascertain the presence of microcytic anemia since the stated condition is elaborated as an MCV of not higher than 80fl. The patient’s nutrient deficiency of vitamin B12 and iron is indicated by the increment of RDW of 20.5 percent .a healthy female individual red cell distribution width should range between 12.2-16.1 percent. In the case of platelets, a youthful female individual should range from 150,000 to 450,000 per microliter of blood. In this case, the patient platelet count (483 k/cu mm) indicates anemia of chronic disease or iron deficiency (Sealock et al., 2016).

Anemia can cause a condition in which there is a deficiency in the concentration of hemoglobin and an inadequate number of erythrocytes. RBCs are involved in the transportation of oxygen, an insufficient amount of (O2) reaching the body tissues leads to tissue hypoxia. The manifestation of clinical anemia is caused by the slow body response to tissue hypoxia. A patient suffering from anemia has symptoms such as increased respiratory rate and heart rate. Signs and symptoms of chronic anemia include chest pain, exertional dyspnea, and fatigue, among others. Tissue hypoxia causes palpitations, and chest pain frequently results in the reduced oxygen-carrying capacity of the blood (Bramble, 2017).

References

Basavanthappa, B. (2011). Nursing management of respiratory problems. Essentials of Medical Surgical Nursing, 53-53. https://doi.org/10.5005/jp/books/11404_3

Bramble, M. (2017). Nursing for wellness in older adults S. Hunter and C. Miller. Wolters Kluwer, Philadelphia, 2016. ISBN 9781922228758 (paperback). Australasian Journal on Ageing, 36(1), 77-77. https://doi.org/10.1111/ajag.12387

Sealock, K., Lilley, L. L., Collins, S. R., & Snyder, J. S. (2016). Pharmacology for Canadian health care practice. Elsevier Health Sciences.