Hematopoietic:J.D. is a 37 years old white woman who presents to her gynecologistcomplaining of a 2-month history of intermenstrual bleeding, menorrhagia,increased urinary frequency, mild incontinence, extreme fatigue, and weakness.Her menstrual period occurs every 28 days and lately there have been 6 days ofheavy flow and cramping. She denies abdominal distension, back-ache, andconstipation. She has not had her usual energy levels since before her lastpregnancy.
Past Medical History (PMH):Upon reviewing her past medical history, the gynecologist notes that herpatient is a G5P5with four pregnancies within four years, the last infanthaving been delivered vaginally four months ago. All five pregnancies wereunremarkable and without delivery complications. All infants were born healthy.Patient history also reveals a 3-year history of osteoarthritis in the leftknee, probably the result of sustaining significant trauma to her knee in anMVA when she was 9 years old. When asked what OTC medications she is currentlytaking for her pain and for how long she has been taking them, she reveals thatshe started taking ibuprofen, three tablets each day, about 2.5 years ago forher left knee. Due to a slowly progressive increase in pain and a loss ofadequate relief with three tablets, she doubled the daily dose of ibuprofen.Upon the recommendation from her nurse practitioner and because long-termibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on aregular basis to prevent gastrointestinal bleeding. Patient history alsoreveals a 3-year history of HTN for which she is now being treated with adiuretic and a centrally acting antihypertensive drug. She has had no previoussurgeries.
Case Study Questions1. Namethe contributing factors on J.D that might put her at risk to develop irondeficiency anemia.2. Withinthe case study, describe the reasons why J.D. might be presenting constipationand or dehydration.3. WhyVitamin B12 and folic acid are important on the erythropoiesis? Whatabnormalities their deficiency might cause on the red blood cells?4. Thegynecologist is suspecting that J.D. might be experiencing iron deficiencyanemia.In order to support the diagnosis, list and describe the clinical symptoms thatJ.D. might have positive for Iron deficiency anemia.5. If thepatient is diagnosed with iron deficiency anemia, what do you expect to find assigns of this type of anemia? List and describe.6. Labsresults came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL;red blood cells are smaller and paler in color than normal. Research list anddescribe for appropriate recommendations and treatments for J.D.
CardiovascularMr. W.G. is a 53-year-old white man who began to experiencechest discomfort while playing tennis with a friend. At first, he attributedhis discomfort to the heat and having had a large breakfast. Gradually,however, discomfort intensified to a crushing sensation in the sternal area andthe pain seemed to spread upward into his neck and lower jaw. The nature of thepain did not seem to change with deep breathing. When Mr. G. complained of feelingnauseated and began rubbing his chest, his tennis partner was concerned thathis friend was having a heart attack and called 911 on his cell phone. Thepatient was transported to the ED of the nearest hospital and arrived within 30minutes of the onset of chest pain. In route to the hospital, the patient wasplaced on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain haseased slightly in the last 15 minutes but is still significant; was 9/10 inseverity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets.He denies chills.
Case Study Questions1. Forpatients at risk of developing coronary artery disease and patients diagnosedwith acute myocardial infarct, describe the modifiable and non-modifiable riskfactors.2. Whatwould you expect to see on Mr. W.G. EKG and which findings described on thecase are compatible with the acute coronary event?3. Havingonly the opportunity to choose one laboratory test to confirm the acutemyocardial infarct, which would be the most specific laboratory test you wouldchoose and why?4. How doyou explain that Mr. W.G temperature has increased after his Myocardial Infarct,when that can be observed and for how long? Base your answer on thepathophysiology of the event.5. Explainto Mr. W.G. why he was experiencing pain during his Myocardial Infarct.Elaborate and support your answer.
SubmissionInstructions:·Include both case studies in yourpost.·Your initial post should be at least 500 words, formattedand cited in current APA 7thstyle with support from at least 3 academicsources.Turnitin similarity should be lessthan 14%Each student must adhere to the formatting ruleswhich include but is not limited to in-text citations andreferences outlined in the 7th Edition of the APAhandbook. For example, this tool doesnot italicize journals or book names.Analyze your assessment findingsand the family’s answers to your questions.Quotes “…” cannotbe used at a higherlearning level for your assignments, so sentences need to be paraphrasedand referenced.Acceptablereferences include scholarly journal articles or primary legal sources(statutes, court opinions), journal articles, and books published in the last five years. No websites to be referenced without priorapproval.
Textbook(s)Delugash, L., Story, L. (2020).Applied Pathophysiology for the Advanced Practice Nurse. Burlington, MA: Jones and BartlettLearning. ISBN: 978-1284150452
Read·Delugash, L., Story, L. (2020).o Chapter 3CH03.pptx DownloadCH03.pptxo Chapter 4o CH04.pptx DownloadCH04.pptxWatch·Chapter 3: Hematopoietic System (43:36)STU.(2021). Chapter 3: Hematopoieticsystem [Video]. Studio.
·Chapter 4: Cardiovascular Function (54:48)STU.(2021). Chapter 4: Cardiovascularfunction [Video]. Studio.
·Cardiac Conduction System and Understanding ECG (3:45)Alila Medical Media. (2014, April 29). Cardiac conduction system andunderstanding ECG, animation [Video]. YouTube. https://youtu.be/RYZ4daFwMa8Cardiac Conduction System and UnderstandingECG, Animation. (Links to an externalsite.)·Blood Flow (1:29)Argonne National Laboratory. (2010, October 13). Blood flow: Multi-scalemodeling and visualization [Video]. YouTube. https://youtu.be/0hibGZi8TWsBlood Flow: Multi-scale Modeling and Visualization (Links to an externalsite.)· 3.Iron-deficiency anemia (Links to an externalsite.)Iron-deficiency anemia. (2020).American Society of Hematology.https://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx6.Iron-deficiency anemia (Links to an externalsite.)National Institutes of Health. (2020, August 18). Iron-deficiency anemia. NHLBI, NIH. https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia (Links to an externalsite.)7.Hematopoiesis (Links to an externalsite.)Jaganathan-Bogdan, M., & Zon, L. I. (2013, June 15). Hematopoiesis. PubMed Central.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666375/8.The hematopoietic system (Links to an externalsite.)The hematopoietic system – Clinical methods –NCBI bookshelf. (1990). National Center for Biotechnology Information.https://www.ncbi.nlm.nih.gov/books/NBK1741/11.What is heart failure? (Links to an externalsite.)What is heart failure? (2017,May 31). American Heart Association.https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure12.What is high blood pressure? (Links to an externalsite.)What is high blood pressure? (2016,October 31). American Heart Association.https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure15.Heart attack (Myocardialinfarction) (Links to an externalsite.)Harvard Health Publishing. (2020, June 17). Heart attack (Myocardial infarction). HarvardHealth.https://www.health.harvard.edu/a_to_z/heart-attack-myocardial-infarction-a-to-z16.Cardiovascular system (Links to an externalsite.)Taylor, T. (2020, July 29). Cardiovascularsystem. Innerbody.https://www.innerbody.com/image/cardov.html17.Circulatory shock (Links to an externalsite.)Vincent, J. L., & De Backer, D. (2013, October 31). Circulatoryshock. New England Journal ofMedicine. https://www.nejm.org/doi/full/10.1056/NEJMra1208943