Anemia Patient Profile D.G., a 72-year-old male whose wife died six months ago, is brought to the health care provider by his daughter because he is not eating much and has been lethargic and sleeping a lot. He has a history of hyperlipidemia for which he takes niacin/lovastatin (Advicor) 500/20 mg PO daily at bedtime. Subjective Data Has been unusually tired for the past couple of months Is frequently short of breath and sometimes feels like his “ heart is pounding” Has lost weight because his wife always used to cook for him and he doesn’t cook for himself Describes a typical daily meal as coffee and a donut for breakfast, a hot dog and lemonade for lunch, and a jelly sandwich on white bread and coffee for supper. Objective Data Physical Examination: Blood pressure 118/72, pulse 98, temperature 98.2° F, respirations 16 Oxygen saturation 92% on room air Height 5’6”, weight 135 lbs, BMI 21.7 kg/m2 S1 and S2 auscultated and regular Bilateral radial pulses +3 and regular Lungs clear bilaterally Diagnostic Studies RBC 3,300,000/µL Hemoglobin 8.3 g/dL Hematocrit 24% MCV 73 fL MCH 23 pg WBC 9,100/µL Platelets 250,000/µL Iron 28 mcg/dL Ferritin 14 ng/mL Cobalamin 600 pg/mL Folate 10 ng/mL Question: Interpret D.G.’s laboratory results. Question: Based on the laboratory data and assessment findings, the health care provider diagnoses D.G. with iron deficiency anemia. What clinical manifestations of iron deficiency anemia does D.G. have? Question: Explain iron deficiency anemia and identify the probable cause of D.G’s anemia. Question: How is iron deficiency anemia treated? Question: Identify dietary iron sources to include in D.G.’s teaching. Question: What are important points to include when teaching patients taking oral iron supplements? Question: What evaluative parameters could you use to determine whether D.G.’s anemia is resolving?
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