NRNP 6540 NRNP KNOWLEDGE CHECK WEEK 8fewer side effects.
QUESTION 2
1. Describe two ways that iron deficiency anemia can occur.
Twenty seven percent of the population worldwide is affected by anemia. Sixty percent
of the anemia cases in the world are caused by IDA. IDA occurs in two to five per...
what would you prescribe for your older female patient diagnosed with iron deficiency anemia as first line treat
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NRNP 6540 NRNP KNOWLEDGE CHECK WEEK 8
QUESTION 1
1. What would you prescribe for your older female patient diagnosed with iron
deficiency anemia as first-line treatment?
The first line of treatment for iron deficiency anemia (IDA) is oral iron therapy. Ferrous
sulfate 325 mg (65 mg of elemental iron) twice or three times a day. More severe cases will
require 100-200 mg of elemental iron. There are no guidelines with regards to dosage in older
adults but studies revealed that lower doses achieved the same results with fewer side effects.
QUESTION 2
1. Describe two ways that iron deficiency anemia can occur.
Twenty seven percent of the population worldwide is affected by anemia. Sixty percent
of the anemia cases in the world are caused by IDA. IDA occurs in two to five percent
of postmenopausal women and adult men in developed countries. IDA can occur due to
inadequate intake, decreased absorption, increased demand, or increased loss of iron.
Decreased oral intake or inadequate diet, especially in older adults, can result in anemia.
Inadequate nutrition like caloric and protein restriction results in decreased iron in the body.
Helicobacter pylori infection can cause decreased iron absorption and can also cause
micro erosion that leads to bleeding and may result in IDA.
QUESTION 3
1. Albert, your 89-year-old male patient, was diagnosed with CLL, chronic lymphocytic
leukemia. Describe the incidence, most common age affected, and gender most affected.
CLL is a common disease in the elderly and is the most common leukemia in the adult
population in the Western world. CLL accounts to about 25% of adult leukemias and about 25%
of non-Hodgkin’s lymphoma. The disease is extremely rare in the pediatrics population and also
rare under adults under 40 years. Average age of CLL cases is 71 years and men are more likely
to have this condition as compared to women.
QUESTION 4
1. Describe at least four methods by which an older person can develop iron deficiency
anemia.
IDA can occur due to inadequate intake, decreased absorption, increased demand, or
increased loss of iron. While increased demand is common in children and pregnant women, insufficient
dietary iron intake, gastrointestinal malabsorption and/or increased blood losses are the most common causes of ID
in older individuals.
IDA due to poor nutrition (decreased oral intake or inadequate diet) is one of the obvious contributing factor
of IDA in the elderly. Inadequate nutrient intake due to poor dentition (decrease red meat consumption results in
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, reduced iron and Vit B12 intake), reduced appetite, reduced tolerance of milk products and loss of intrinsic factor
with aging are well characterized as indirect causes of IDA.
Decreased absorption of iron or iron malabsorption is also relatively frequent in the elderly. Conditions
whose prevalence typically increases with age are represented by Helicobacter pylori infection and atrophic
gastritis. H. pylori infection decreases iron absorption and also leads to micro erosions that cause
bleeding. Meanwhile, proton pump inhibitors, H2 blockers, and antacids contribute to
iron malabsorption being gastric acid is necessary for optimal intestinal absorption of Iron.
Surgeries like gastrectomy, duodenal bypass, or bariatric surgery can result in decreased
iron absorption.
Increased loss of iron due to chronic blood loss, mostly from the GI tract, contributes to IDA. Examples of
GI causes are peptic ulcer disease, gastritis, hiatal hernia, mucosal ulceration, neoplasms, diverticular disease, or GI
bleed from inflammatory bowel disease all can contribute to IDA. Medications that are highly prevalent in older
adults like salicylates and NSAIDs increase GI bleeding causing IDA.
Other causes of bleeding like nose bleed, hematuria, dysfunctional uterine bleeding, and bleeding diathesis
are other possible methods contributing to IDA in older adults.
QUESTION 5
1. Margery is a 78-year-old female who comes to you with non-specific complaints of
fatigue and red blood in the toilet after having stools she attributes to her hemorrhoids
bleeding for the past 4 months. What type of anemia would you suspect?
In Mary’s case, whose complaints include non-specific complaints of fatigue and red
blood in the toilet after having stools and which she attributes to hemorrhoids bleeding for the
past 4 months, the practitioner could consider iron deficiency anemia (IDA) as the differential
diagnosis. Non-specific fatigue is one of the signs of IDA. Chronic blood loss, mostly from the
GI tract, is one of the contributing factors of IDA. Being that the bleeding has been happening
for the past four months, further assessment should be performed to check the amount and
frequency of bleeding or check other possible causes of the bleeding. It is vital to evaluate other
causes of anemia when presented with hemorrhoidal bleeding with anemia. Treatment of the
hemorrhoids should be undertaken and evaluate rapid return of hemoglobin concentration within
two to six months. Failure to recover should prompt further or repeated evaluation for other
causes of bleeding.
QUESTION 6
1. Briefly describe the mechanism of immune thrombocytopenic purpura (ITP).
Immune thrombocytopenic purpura (ITP) is an acquired medical condition evidence by
thrombocytopenia (low blood platelet count) from immune-mediated, accelerated platelet
destruction in combination with inadequate platelet production and T-cell mediated effects. ITP
is classified as primary (idiopathic) or secondary. Primary is idiopathic (unknown cause).
Secondary ITP occurs in the presence of other autoimmune conditions like systemic lupus
erythematosus, HIV, or HCV, among others.
Mechanism is not fully understood but current literature shows that increased platelet
destruction by the immune system and megakaryocytopoiesis abnormalities are associated with
This study source was downloaded by 100000832361371 from CourseHero.com on 04-25-2022 07:55:26 GMT -05:00
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