Hematopoietic Disorders: A Case Study Analysis

by | Jun 20, 2024 | Nursing

 

Hematopoietic:
J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy.

Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries.

Case Study Questions

Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells?
The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

 

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

Sample Answer

Sample Answer

 

Hematopoietic Disorders: A Case Study Analysis

Introduction

Hematopoietic disorders encompass a wide range of conditions affecting the production and function of blood cells. In this case study, we delve into the complex medical history of J.D., a 37-year-old woman presenting with concerning symptoms that point towards hematological issues. Through a detailed analysis, we aim to identify potential contributing factors, understand the manifestations of iron deficiency anemia, and explore appropriate recommendations and treatments for the patient.

Contributing Factors to Iron Deficiency Anemia in J.D.

J.D.’s medical history reveals several factors that may predispose her to iron deficiency anemia. These include:

– Menorrhagia: Excessive menstrual bleeding can lead to significant iron loss over time.
– Frequent Pregnancies: Rapid succession of pregnancies can deplete iron stores in the body.
– Chronic Ibuprofen Use: Prolonged use of ibuprofen, especially at higher doses, can cause gastrointestinal bleeding and subsequent iron deficiency.
– History of Osteoarthritis: Chronic pain conditions may contribute to decreased dietary intake or absorption of iron.

Constipation and Dehydration in J.D.

J.D. might be experiencing constipation and dehydration due to several reasons:

– Dehydration: Increased urinary frequency and mild incontinence could lead to fluid loss and subsequent dehydration.
– Iron Deficiency Anemia: Anemia can result in reduced oxygen delivery to tissues, leading to constipation and fatigue.

Importance of Vitamin B12 and Folic Acid in Erythropoiesis

Vitamin B12 and folic acid play crucial roles in red blood cell production. Their deficiencies can lead to:

– Megaloblastic Anemia: A condition characterized by large, immature red blood cells, resulting in decreased oxygen-carrying capacity.
– Neurological Complications: Vitamin B12 deficiency can lead to neurological symptoms due to nerve damage.

Clinical Symptoms of Iron Deficiency Anemia in J.D.

If J.D. is diagnosed with iron deficiency anemia, she may exhibit symptoms such as:

– Fatigue: Due to decreased oxygen delivery to tissues.
– Weakness: Resulting from reduced energy production.
– Pallor: Skin and mucous membrane pallor due to decreased hemoglobin levels.

Signs of Iron Deficiency Anemia in Lab Results

Based on J.D.’s lab results showing low hemoglobin (Hb) levels, decreased hematocrit (Hct), low ferritin levels, and smaller, paler red blood cells, the signs of iron deficiency anemia are evident. Additional findings may include microcytic hypochromic red blood cells on peripheral blood smear.

Recommendations and Treatments for J.D.

To address J.D.’s iron deficiency anemia, the following recommendations and treatments are recommended:

– Iron Supplementation: Prescribe oral iron supplements to replenish iron stores.
– Dietary Modifications: Encourage consumption of iron-rich foods such as red meat, leafy greens, and fortified cereals.
– Monitoring: Regular follow-up visits to track response to treatment and adjust management if needed.

In conclusion, the case study of J.D. highlights the intricate interplay of factors contributing to hematopoietic disorders. By understanding the underlying mechanisms and implementing appropriate management strategies, healthcare providers can effectively address the complex needs of patients presenting with hematological abnormalities.

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