Nursing homework help
\nStudents must review the case study and answer all questions with a scholarly response using Help write my thesis – APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document<\/p>\n
The answers must be in your own words with reference to the journal or book where you found the evidence to your answer.<\/p>\n
Answers must be scholarly and be 3-4 sentences in length with rationale and explanation. No Straight forward \/ Simple answer will be accepted.<\/p>\n
All answers to case studies must have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study
\nPagana: Mosby\u2019s Manual of Diagnostic and Laboratory Tests, 6th Edition
\nIron-Deficiency Anemia
\nCase Study
\nA 72-year-old man developed chest pain whenever he was physically active. The pain ceased on
\nstopping his activity. He has no history of heart or lung disease. His physical examination was
\nnormal except for notable pallor.
\nStudies Result
\nElectrocardiogram (EKG), p. 485 Ischemia noted in anterior leads
\nChest x-ray study, p. 956 No active disease
\nComplete blood count (CBC), p.
\n156
\nRed blood cell (RBC) count, p.
\n396
\n2.1 million\/mm (normal: 4.7\u20136.1 million\/mm)
\nRBC indices, p. 399
\nMean corpuscular volume
\n(MCV)
\n72 mm3
\n(normal: 80\u201395 mm3
\n)
\nMean corpuscular hemoglobin
\n(MCH)
\n22 pg (normal: 27\u201331 pg)
\nMean corpuscular hemoglobin
\nconcentration (MCHC)
\n21 pg (normal: 27\u201331 pg)
\nRed blood cell distribution width
\n(RDW)
\n9% (normal: 11%\u201314.5%)
\nHemoglobin (Hgb), p. 251 5.4 g\/dL (normal: 14\u201318 g\/dL)
\nHematocrit (Hct), p. 248 18% (normal: 42%\u201352%)
\nWhite blood cell (WBC) count, p.
\n466
\n7800\/mm3
\n(normal: 4,500\u201310,000\/mcL)
\nWBC differential count, p. 466 Normal differential
\nPlatelet count (thrombocyte
\ncount), p. 362
\nWithin normal limits (WNL) (normal: 150,000\u2013
\n400,000\/mm3
\n)
\nHalf-life of RBC 26\u201330 days (normal)
\nLiver\/spleen ratio, p. 750 1:1 (normal)
\nSpleen\/pericardium ratio <2:1 (normal)
\nReticulocyte count, p. 407 3.0% (normal: 0.5%\u20132.0%)
\nHaptoglobin, p. 245 122 mg\/dL (normal: 100\u2013150 mg\/dL)
\nBlood typing, p. 114 O+
\nIron level studies, p. 287
\nIron 42 (normal: 65\u2013175 mcg\/dL)
\nTotal iron-binding capacity
\n(TIBC)
\n500 (normal: 250\u2013420 mcg\/dL)
\nTransferrin (siderophilin) 200 mg\/dL (normal: 215\u2013365 mg\/dL)
\nTransferrin saturation 15% (normal: 20%\u201350%)
\nCase Studies
\nCopyright \u00a9 2018 by Elsevier Inc. All rights reserved.
\n2
\nFerritin, p. 211 8 ng\/mL (normal: 12\u2013300 ng\/mL)
\nVitamin B12, p. 460 140 pg\/mL (normal: 100\u2013700 pg\/mL)
\nFolic acid, p. 218 12 mg\/mL (normal: 5\u201320 mg\/mL or 14\u201334 mmol\/L)
\nDiagnostic Analysis
\nThe patient was found to be significantly anemic. His angina was related to his anemia. His
\nnormal RBC survival studies and normal haptoglobin eliminated the possibility of hemolysis..
\nHis RBCs were small and hypochromic. His iron studies were compatible with iron deficiency.
\nHis marrow was inadequate for the degree of anemia because his iron level was reduced.
\nOn transfusion of O-positive blood, his angina disappeared. While receiving his third unit of
\npacked RBCs, he developed an elevated temperature to 38.5\u00b0C, muscle aches, and back pain.
\nThe transfusion was stopped, and the following studies were performed:
\nStudies Results
\nHgb, p. 251 7.6 g\/dL
\nHct, p. 248 24%
\nDirect Coombs test, p. 157 Positive; agglutination (normal: negative)
\nPlatelet count, p. 362 85,000\/mm3
\nPlatelet antibody, p. 360 Positive (normal: negative)
\nHaptoglobin, p. 245 78 mg\/dL
\nDiagnostic Analysis
\nThe patient was experiencing a blood transfusion incompatibility reaction. His direct Coombs
\ntest and haptoglobin studies indicated some hemolysis because of the reaction. His platelet count
\ndropped because of antiplatelet antibodies, probably the same ABO antibodies that caused the
\nRBC reaction.
\nHe was given iron orally over the next 3 weeks, and his Hgb level improved. A rectal
\nexamination indicated that his stool was positive for occult blood. Colonoscopy indicated a rightside colon cancer, which was removed 4 weeks after his initial presentation. He tolerated the
\nsurgery well.
\nCritical Thinking Questions
\n1. What was the cause of this patient’s iron-deficiency anemia?
\n2. Explain the relationship between anemia and angina.
\n3. Would your recommend B12 and Folic Acid to this patient? Explain your rationale for
\nthe answer
\n4. What other questions would you ask to this patient and what would be your rationale for
\nthem?<\/p>\n
—
\nCopyright \u00a9 2018 by Elsevier Inc. All rights reserved.
\nPagana: Mosby\u2019s Manual of Diagnostic and Laboratory Tests, 6th Edition
\nAIDS (Acquired Immunodeficiency Syndrome)
\nCase Studies
\nThe patient, a 30-year-old homosexual man, complained of unexplained weight loss, chronic
\ndiarrhea, and respiratory congestion during the past 6 months. Physical examination revealed
\nright-sided pneumonitis. The following studies were performed:
\nStudies Results
\nComplete blood cell count (CBC), p. 156
\nHemoglobin (Hgb), p. 251 12 g\/dL (normal: 14\u201318 g\/dL)
\nHematocrit (Hct), p. 248 36% (normal: 42%\u201352%)
\nChest x-ray, p. 956 Right-sided consolidation affecting the posterior
\nlower lung
\nBronchoscopy, p. 526 No tumor seen
\nLung biopsy, p. 688 Pneumocystis jiroveci pneumonia (PCP)
\nStool culture, p. 797 Cryptosporidium muris
\nAcquired immunodeficiency syndrome
\n(AIDS) serology, p. 265
\np24 antigen Positive
\nEnzyme-linked immunosorbent assay
\n(ELISA)
\nPositive
\nWestern blot Positive
\nLymphocyte immunophenotyping, p. 274
\nTotal CD4 280 (normal: 600\u20131500 cells\/L)
\nCD4% 18% (normal: 60%\u201375%)
\nCD4\/CD8 ratio 0.58 (normal: >1.0)
\nHuman immune deficiency virus (HIV)
\nviral load, p. 265
\n75,000 copies\/mL
\nDiagnostic Analysis
\nThe detection of Pneumocystis jiroveci pneumonia (PCP) supports the diagnosis of AIDS. PCP is
\nan opportunistic infection occurring only in immunocompromised patients and is the most
\ncommon infection in persons with AIDS. The patient\u2019s diarrhea was caused by Cryptosporidium
\nmuris, an enteric pathogen, which occurs frequently with AIDS and can be identified on a stool
\nculture. The AIDS serology tests made the diagnoses. His viral load is significant, and his
\nprognosis is poor.
\nThe patient was hospitalized for a short time for treatment of PCP. Several months after he was
\ndischarged, he developed Kaposi sarcoma. He developed psychoneurologic problems eventually
\nand died 18 months after the AIDS diagnosis.
\nCase Studies
\nCopyright \u00a9 2018 by Elsevier Inc. All rights reserved.
\n2
\nCritical Thinking Questions
\n1. What is the relationship between levels of CD4 lymphocytes and the likelihood of
\nclinical complications from AIDS?
\n2. Why does the United States Public Health Service recommend monitoring CD4
\ncounts every 3\u20136 months in patients infected with HIV?
\n3. This is patient seems to be unaware of his diagnosis of HIV\/AIDS. How would you
\napproach to your patient to inform about his diagnosis?
\n4. Is this a reportable disease in Florida? If yes. What is your responsibility as a
\nprovider?
\n.<\/p>\n","protected":false},"excerpt":{"rendered":"
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