You should respond to at least two of your peers by extending or adding additional nuance to their posts. Formatted and cited in current APA style 7th edition with support from at least 2 academic sources that within the last five years. -No website (to be reference without prior approval) -Quotes cannot be use at higher learning level for your assignment, so sentences need to be paraphrased and reference -Acceptable references include scholarly journal articles or primary legal sources (Statutes, Court opinions) Journal articles and books. Peer 1 Discussion board 2AP (S.S) Hematopoietic Discussion Iron deficiency anemia is a risk factor for those with bleeding disorders as well as those taking over the counter medications for ulcer disease. Iron deficiency anemia seems to be a side effect for those taking high doses of over-the-counter medications ( Imai et al).The long-term use of over-the-counter medicine can contribute to developing anemia due to the risk of gastrointestinal bleeding. Also, the patient has menorrhagia, showing significant blood loss. This added effect leads to their diagnosis of anemia. She is experiencing dehydration due to significant urine loss. I would follow up to see if she is diabetic as she may be experiencing diabetic like symptoms with her urine loss and fatigue. Diabetics tend to feel thirstier because they are constantly losing fluids when the blood sugar is uncontrolled. Anemia has added factors including dehydration, which in turn leads to a cascade of events including constipation. Without many fluids in the body every system gets affected including blood pressure, kidney function, and gastrointestinal health. Folate and vitamin B12 are important in blood health. They contain a substance that has purines that assist in the process of developing new cells, without this factor they don’t develop, and death of the cell occurs. (Koury MJ, 2004). Cells are constantly being destroyed and regenerated and an important factor is having good nutrition containing foods that promote development of fresh red blood cells. The genetic component uses purines from folate and B12 to proliferate the cells. is experiencing anemia symptoms based on the following factors mentioned in her history and physical, they include heavy menstruation, fatigue, and constipation. Each symptoms is an added effect to her symptoms. For example, dehydration can lead to constipation as there isnt enough fiber and water to allow for stool passage. She mentions her energy tends to be low and this is very common in those with anemia who have had multiple pregnancies. She tends to lose a lot of blood during her period cycles leading to an added effect as well. A well-balanced nutrition that increases her blood cell count is important for her to maintain adequate health. The types of iron deficiency anemia I expect to see, number one is fatigue, I would ask if she had any palpitations, shortness of breath, irregular heart rhythms. Also, physical symptoms would show brittle nails and paleness of the skin. Anemia patients also experience shortness of breath at times because the lack of oxygenated red blood cells reaching to their point. Normal ferritin levels are between 11 to 307, JD is within 9 range. This shows she is deficient in iron and would have enrich her diet supplementation in iron foods, such as beans, organic meats, and greens. Based on her lab results she tends to run on the lower end of the spectrum and would need to add supplementation to her meals. A reference to nutritionist and providing her a written material and verbal understanding of the foods she needs to eat would be included in her plan of care. Besides the supplementation an added exercise regimen and diet counsel would improve her overall outlook in health management Cardiovascular discussion Heart disease is the number one disease affecting many individuals around the world. There are modifiable risk factors and non-modifiable risk factors. As far as the modifiable risk factors, including controlling diet, obesity, diabetes, blood pressure, exercise, smoking and stress all add to the disease but can be controlled. (Hajar, 2017). So why does it still affect so many? The lack of education and resources are the answer. Controlling these factors reduce risk almost ten times making it crucial to include in patient management and education. Non modifiable risk factors include genetics of family history. As you can see the modifiable risk factors are far more common and has a better outcome in bringing about change. Although patient arrived in 30 minutes for care, during that time frame, cardiac event was already damaging the heart cells. This is important because we cannot bring back those heart cells and a certain part of the heart is unable to function leaving to hardening of the surrounding muscle. This is in fact true based on the inference that the sublingual nitroglycerin did not alleviate as much as it was intended too. The case study stated that the patients pain went from 9 to 7, meaning the cardiac event is has done significant damage to the heart cells. Based on the presentation of the patient I would expect to see high cardiac work up including BNP, and high troponin levels. The EKG would show ST elevation, which is the hallmark sign of a cardiac infarction as the V3 and V4 leads on the EKG correspond to presentation in someone experiencing a debilitating cardiac event (Aslanger E. K, 2020 et al). The factor that show it is a cardiac event mentioned in the case study include crushing sensation to the sternal area spreading to the jaw, shortness of breath and the feeling of nausea. According to an article on RCPA, one laboratory test to confirm a myocardial infarction is troponin levels, I and T are they are the most sensitive in this matter. This is because proteins are released when heart damage occurs. Temperature increases when a cardiac event occurs and the higher the temperature the larger was the myocardial infarction. The temperature can be measured up to 3 days before it goes back to normal range. EThis causes the muscle to not receive the nutrients causing ischemia, leading to chest pressure and pain that the patient felt. Chest pressure can be caused by many things, but a myocardial infarction needs to be ruled out. When pain does not subside over time and patients continue to have pain throughout the day, early detection and action is vital. This is because the longer the chest pressure continues the more muscle cells get damaged. The muscle cells also dont receive the oxygenated red blood cells leading to death of the part of the heart muscle, making early intervention critical. Peer 2 Discussion Board 2 AP(.) Hematopoietic Our patient year female presents with many risk factors to lead to iron deficiency anemia diagnosis. The patient has had five children, four of which were borne in the last four years. (Zulfiqar, 2021)Patient provides information about daily intake of ibuprofen, which can increase bleeding tendencies including 2 months of intermenstrual bleeding, and history of peptic ulcers. (Dlugasch, 2021) Patient has been placed on a diuretic for her hypertension. This will increase urination and draw fluid out of the body, increasing dehydration. With less fluid in the body, the less water in the intestines to help bowel movements. With a deficiency in folic acid and Vitamin B12, which are needed for our cellular dna, results in abnormal red blood cells and a decrease number of RBCs. ( Zulfiqar) The patient has some classic symptoms of iron deficiency anemia, excess fatigue, weakness, abdomen distention and body aches, Some other clinical signs and symptoms may be brittle nails, decrease appetite, delayed healing, headaches, Once lab work confirms the diagnosis of iron deficiency anemia, the treatment is to replace the iron with supplements and diet. Cardiovascular: Our patient . who is 53 yr male who has been diagnosed with acute myocardial infarction has modifiable risk factor that can be corrected. These would include diet, medications exercise. Non modifiable risk factors are family and genetic traits for risk for cardiovascular disease. When observing and electrocardiogram on a patient, and are looking for acute myocardial infarction, there is usually changes in the ST segment. After looking at EKG, cardiac labs are drawn to confirm, CK MB, troponin and mycoglobin levels, and are usually drawn every 6 to 8 hours to observe the trend. If a myocardial infarct is confirmed and patient is agreeable to treatment the door to table time to ensure best results is 90 minutes. Some people with run a fever after having a myocardial infarction and receiving treatment, nitroglycerin, is a vasodilator and can increase patient temperature, (Dlugasch, 2021) When a patient is experiencing a myocardial infarction, most will present with a crushing, heavy feeling over their chest, with radiation down the arm or up the neck. Some will present with epigastric pain. Most women present with back pain. This pain is usually relevant to the artieries in the heart that are being affected by the blockage.Show more
