NR 283 Week 4 Discussions: Mr. X, age 57, presented to his physician with marked fatigue…)
3 views 0 purchase
Course
NR 283
Institution
Chamberlain College Of Nursing
Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately, he also has been experiencing a tingling feeling in his toes and a f eeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of eryt...
Mr. X, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea,
and a sore, swollen tongue. Lately, he also has been experiencing a tingling feeling in his toes
and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced
number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes,
including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were
below normal. Additional tests confirm pernicious anemia.
Discussion Questions
1. Relate the pathophysiology of pernicious anemia to the manifestations listed above.
Pernicious anemia is a common kind of megaloblastic anemia caused by vitamin
B12 malabsorption due to a shortage of intrinsic factor (IF) produced in the gastric
mucosa glands (Hubert et al., 2018, pg.197). For Mr. X, Hemoglobin and vitamin B12
levels in the blood were both low.
2. Discuss how gastric abnormalities contribute to vitamin B12 and iron deficiency and
how vitamin B12 deficiency causes complications associated with pernicious anemia.
Vitamin B12 and iron deficiencies are triggered by gastric abnormalities. Intrinsic
factor is a stomach-produced protein. It aids in the absorption of vitamin B12. An
autoimmune response produces a deficiency of intrinsic factors in some people. People
with pernicious anemia are unable to absorb enough vitamin B12 from their food. This is
due to a deficiency of intrinsic factors. Vitamin B12 insufficiency is caused by a shortage
of this protein (NHLBI).
Pernicious anemia complications are caused by a lack of vitamin B12. Some
complications include Nerve damage, unsteadiness, loss of balance, difficulty walking,
weakened bones, hip fractures, confusion, dementia, depression, and memory loss.
This study source was downloaded by 100000847795904 from CourseHero.com on 06-21-2022 10:37:46 GMT -05:00
3. Discuss other tests that could be performed to diagnose this type of anemia.
Tests performed to diagnose Pernicious anemia include Schilling test, microscopic
examination, complete blood count, and bone marrow tests (Hubert et al., 2018, pg.199).
4. Discuss the treatment available and the limitations.
Pregnant women and vegetarians should take oral vitamins as a preventative
measure. For those with pernicious anemia, vitamin B12 is given as an injectable as
replacement therapy. Pernicious anemia should be diagnosed and treated as soon as
possible to avoid heart stress and brain harm (Hubert et al., 2018, pg.199). A family
history of pernicious anemia, being of Northern European or Scandinavian heritage and
having a history of autoimmune endocrine disorders are all risk factors for the condition.
Work cited:
Hubert, R., & VanMeter, K. (2018). Gould's pathophysiology for the health professions.
(6th ed.). Elsevier.
Pernicious Anemia. (n.d.). NHLBI, NIH.
https://www.nhlbi.nih.gov/health-topics/pernicious-anemia.
Part-2
Ms. L, a 19-year-old woman with no previous medical history, was involved in a serious
automobile accident in which her best friend died. Examination by EMT personnel first on the
scene revealed she had only minor scrapes and bruises and no sign of head trauma. While en
route by ambulance to the hospital, Ms. L complained of thirst and appeared restless. Further
examination indicated a rapid pulse and respiration, with her blood pressure now at 100/60 mm
This study source was downloaded by 100000847795904 from CourseHero.com on 06-21-2022 10:37:46 GMT -05:00
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller ProfGoodlucK. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
