Case Study #1
Introduction
Blood transports nutrients and oxygen to all the organs and tissues and also carries away tissue waste and debris. Chemical messengers, clotting factors, anticoagulant factors, cells that fight bacteria and numerous other components are carried by the blood. To be effective, the blood must stay liquid, but not too liquid, and it must be pumped through the circulation system to all tissues. Alterations in the red blood cell, the clotting components, the blood vessels, and the ability of the heart affect the entire system.
The erythrocyte, or red blood cell (RBC), is the most numerous component of the blood. The function of the RBC is to transport oxygen to the tissues and also carry carbon dioxide back to the lungs. A complete blood count (CBC) is essential in evaluating the status of the hemapoetic system. The RBC count that is decreased may indicate an anemia. A reticulocyte count, which is more or less than 1% of the RBC count, helps determine if the cause of the anemia is due to blood loss, increased RBC destruction, or the bone marrow not functioning. An increase in reticulocytes may be seen in illnesses like anemia as the body tries to compensate.
Literature Review
Anemia
Iron deficiency anemia
Iron deficiency anemia is the most widespread kind of anemia worldwide. A dietary deficiency of iron is often the cause, but chronic blood loss has also been implicated. The RBCs are microcytic and hypochromic. They may also exhibit an irregular shape (poikilocytosis). The signs and symptoms with this anemia will include pallor, fatigue, palpitations, dyspnea, tachycardia, and sores in the corners of the mouth. The treatment for this condition is supplemental iron. Ms. A is suffering from iron deficiency anemia; she experiences dizziness, joint stiffness, shortness of breath and menorrhagia. Her case worsens during her periods; her symptoms indicate that she has Iron deficiency anemia (Mariell, 2003).
Some people have very harsh illnesses with recurrent vaso-occlusive problems and early morbidity and fatality at their young age, in other cases, the illness can go without being seen until the patient reaches his/her adulthood. For instance in the case of Ms. A, she has hemoglobin of 8 g/dl and this puts her in a very high risk. Her periods are very high that’s why she does not have enough blood in her body and as a result she is having difficulty in breathing and feeling dizzy. This illness can have extensive signs and complications thus affecting every phase or aspect of the patient’s life.
Symptoms
Painful events are very frequent symptoms when it comes iron deficiency anemia. The patient has episodes of pain that occur when the sickle cells get fastened in the vessels of blood thus causing blood flow blockage. These events normally bring about pains in the patients’ hands, their back, their stomach, feet and their chests. In the case of Ms. A she gets stiffness of joints and this is very painful. These pains can be experienced for hours or even days.
Patients also have red-blood cells’ deficiencies. These painful events make one feel very weak and exhausted and this can cause dizziness just like the case of Ms. A. She also experiences breath and low levels of energy and enthusiasm. This is very common among the patients of Iron deficiency anemia. Medical doctors can not really tell which complications a baby born with the illness will have, when they will begin experiencing complications or how severe they will be.
How is Iron deficiency anemia disease diagnosed?
This anemia is diagnosed based on the patient’s medical history; tests and physical examinations are carried out. The doctor gets a treatment plan once the patient has been examined.
How is it treated?
If the patient’s iron-deficiency anemia is harsh, she may obtain red-blood cells’ transfusion. Transfusions need cautious matching of given blood with the receiver’s blood.
Conclusion
Ms. A experiences low blood pressure and increased heart rate, this is a common incident to these patients. Due to the developments that have came up today, many people who are born with this illness, grow up and live normal and healthy lives. It is very imperative to report to your doctor if signs of the illness are diagnosed so that treatment can start early enough. Genetic counseling can also be offered since the disease can be inherited.
Case Study #2
Introduction
The function of the heart is to pump blood through the vessels, deliver nutrients and oxygen to the tissues, and pick up waste products. Considering the pathologies of the heart, one can view them from their effects on stoke volume: cardiac output, preload, afterload, contractility, and heart rate. The sympathetic nervous system for cardiovascular control primarily in the medulla causes the release of norepinephrine, which stimulates the ß-adrenergic receptors on the cardiac cells.
ß1 receptors increase heart and contraction, while ß2 receptors in the coronary arterioles cause vasodilation. Beta blockers such as Toporol and atenolol block norepinephrine, thereby decreasing heart rate and strength of contraction. The parasympathetic nervous system dominates via the vagus nerve, releasing acetylcholine, which maintains or decreases the rate. Atropine, an anticholinergic, is used to block acetylcholine and increase the heart rate. Inflammation and cardiac cell damage secondary to myocardial ischemia or infarction potentially affect the relay of the impulse down the conduction system, causing arrhythmias.
Medical care and treatment plan
Heart failure commonly associated with myocardial infarctions may also be caused by valvular disease, pericarditis, and pulmonary disease. While many patients have what we call congestive heart failure, it identifies the symptoms rather than what areas of the heart are not functioning well. For example, a blocked left anterior descending coronary artery may cause extensive damage to the left ventricle.
With the remodeling process, the ventricle loses its ability to stretch and contract, thereby decreasing the ejection fraction (normally 65% of what is in the left ventricle). As cardiac output decreases, renal perfusion decreases, causing the RAA system to be activated (Porth, 2007). Fluid is retained, increasing the preload, while the sympathetic system increases heart rate and causes vasoconstriction, increasing afterload. Instead of helping the heart, these protective mechanisms actually make it work harder.
Treatment of heart failure involves decreasing fluid volume, slowing the heart rate, increasing oxygen to the heart, and improving circulation. This treatment helps in relieving the symptoms hence making everyday activities easier (Linda, 2007). It reduces the chances of the patient having to be admitted in the hospital. This is the reason why the patient must follow the treatment plan given by the doctor; medicines should also be taken as prescribed.
If the patient experiences side effects from other different prescriptions, they should inform their physician. The doctor can change that dosage to ease the side effects experienced. The lifestyle of the patient should change just like the doctor orders. The patient is also supposed to get medical advice from his/her doctor on which activities to carry out, the work to do and not to do, his/her sex life and what exercises to execute.
The level of activities to carry out depends on how severe the patient’s heart is. The doctor should make sure that he/she keeps all the recommended health appointments including those on laboratory and tests work. These results are greatly needed by the physician incase there is any adjustment need in the patient’s dosage so that dangerous side effects can be avoided.
Family and Patient Education
Living with this disease can bring about anxiety, despair and stress. Mr. P feels agitated and his wife is very worried about his husband illness. It is very vital to talk about your feelings when it comes to your health. The family of Mr. P is going through financial problems because of his declining health; Mr. P even prefers to die. This family should search for professional counseling concerning this health problem. If one is feeling stressed out, the doctor can prescribe medicines or other different types of treatments that can recover the patient’s quality of life.
Mr. P and other patients suffering from this illness should join some support groups that can help them not to feel alone; some patients suffer thinking they are the only ones with the illness (Ida, 2002). You can learn on how to cope with your illness from other patients with the similar disease. Family and friends can greatly help in relieving the feeling of nervousness and depression. Families should always be available to support and comfort their loved one. The patient should not hesitate to say what they feel to their families and what they can do to make him/her condition better.
Conclusion
Heart failure is an ailment that can not be cured. The patient is just required to take medication and follow some treatment plans all through their life. Regardless of the treatment, the disease can get severe with time. The patients may be unable to do as many activities as he used to do before; the severity of his heart determines this. Nonetheless if the patient follows all the steps ordered by the doctor, they can stay healthy for a long time.
References
McCance, K. L., & Huether, S. E. (2006). Pathophysiology: The biological basis for disease in adults and children (5th ed.). St. Louis, MO: Elsevier Mosby.
Porth, C. M. (2007). Essentials of pathophysiology: Concepts of altered health states (2nd ed.). Philadelphia: Lippincott Williams & Wilkins.
Mariell L. J., (2003). Heart failure: a clinician’s guide to ambulatory diagnosis and treatment; Contemporary cardiology. Chicago. Humana Press
Linda K. D. (2007). Nutrition and Diet Therapy. New York. Cengage Learning
Ida M. M., (2002). Home health care nursing. California. Elsevier Health Sciences
