Hematopoietic:

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
1. Name
the contributing factors on J.D that might put her at risk to develop iron
deficiency anemia.
2. Within
the case study, describe the reasons why J.D. might be presenting constipation
and or dehydration.
3. Why
Vitamin B12 and folic acid are important on the erythropoiesis? What
abnormalities their deficiency might cause on the red blood cells?
4. 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.
5. 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.
6. 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.

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience
chest discomfort while playing tennis with a friend. At first, he attributed
his discomfort to the heat and having had a large breakfast. Gradually,
however, discomfort intensified to a crushing sensation in the sternal area and
the pain seemed to spread upward into his neck and lower jaw. The nature of the
pain did not seem to change with deep breathing. When Mr. G. complained of feeling
nauseated and began rubbing his chest, his tennis partner was concerned that
his friend was having a heart attack and called 911 on his cell phone. The
patient was transported to the ED of the nearest hospital and arrived within 30
minutes of the onset of chest pain. In route to the hospital, the patient was
placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325
mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has
eased slightly in the last 15 minutes but is still significant; was 9/10 in
severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets.
He denies chills.

Case Study Questions
1. For
patients at risk of developing coronary artery disease and patients diagnosed
with acute myocardial infarct, describe the modifiable and non-modifiable risk
factors.
2. What
would you expect to see on Mr. W.G. EKG and which findings described on the
case are compatible with the acute coronary event?
3. Having
only the opportunity to choose one laboratory test to confirm the acute
myocardial infarct, which would be the most specific laboratory test you would
choose and why?
4. How do
you explain that Mr. W.G temperature has increased after his Myocardial Infarct,
when that can be observed and for how long? Base your answer on the
pathophysiology of the event.
5. Explain
to Mr. W.G. why he was experiencing pain during his Myocardial Infarct.
Elaborate and support your answer.

Submission
Instructions:
·
Include both case studies in your
post.
·
Your initial post should be at least 500 words, formatted
and cited in current APA 7th
style with support from at least 3 academic
sources.
Turnitin similarity should be less
than 14%
Each student must adhere to the formatting rules
which include but is not limited to in-text citations and
references outlined in the 7th Edition of the APA
handbook. For example, this tool does
not italicize journals or book names.
Analyze your assessment findings
and the family’s answers to your questions.
Quotes “…” cannot
be used at a higher
learning level for your assignments, so sentences need to be paraphrased
and referenced.
Acceptable
references include scholarly journal articles or primary legal sources
(statutes, court opinions), journal articles, and books published in the last five years. No websites to be referenced without prior
approval.

Textbook(s)
Delugash, L., Story, L. (2020).
Applied Pathophysiology for the Advanced Practice Nurse. Burlington, MA: Jones and Bartlett
Learning. ISBN: 978-1284150452

Read
·
Delugash, L., Story, L. (2020).
o Chapter 3
CH03.pptx Download
CH03.pptx
o Chapter 4
o CH04.pptx Download
CH04.pptx
Watch
·
Chapter 3: Hematopoietic System (43:36)
STU.
(2021). Chapter 3: Hematopoietic
system [Video]. Studio.

·
Chapter 4: Cardiovascular Function (54:48)
STU.
(2021). Chapter 4: Cardiovascular
function [Video]. Studio.

·
Cardiac Conduction System and Understanding ECG (3:45)
Alila Medical Media. (2014, April 29). Cardiac conduction system and
understanding ECG, animation [Video]. YouTube. https://youtu.be/RYZ4daFwMa8Cardiac Conduction System and Understanding
ECG, Animation. (Links to an external
site.)
·
Blood Flow (1:29)
Argonne National Laboratory. (2010, October 13). Blood flow: Multi-scale
modeling and visualization [Video]. YouTube. https://youtu.be/0hibGZi8TWsBlood Flow: Multi-scale Modeling and Visualization (Links to an external
site.)
· 3.
Iron-deficiency anemia (Links to an external
site.)
Iron-deficiency anemia. (2020).
American Society of Hematology.
https://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx
6.
Iron-deficiency anemia (Links to an external
site.)
National Institutes of Health. (2020, August 18). Iron-deficiency anemia. NHLBI, NIH. https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia (Links to an external
site.)
7.
Hematopoiesis (Links to an external
site.)
Jaganathan-Bogdan, M., & Zon, L. I. (2013, June 15). Hematopoiesis. PubMed Central.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666375/
8.
The hematopoietic system (Links to an external
site.)
The hematopoietic system – Clinical methods –
NCBI bookshelf. (1990). National Center for Biotechnology Information.
https://www.ncbi.nlm.nih.gov/books/NBK1741/
11.
What is heart failure? (Links to an external
site.)
What is heart failure? (2017,
May 31). American Heart Association.
https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure
12.
What is high blood pressure? (Links to an external
site.)
What is high blood pressure? (2016,
October 31). American Heart Association.
https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure
15.
Heart attack (Myocardial
infarction) (Links to an external
site.)
Harvard Health Publishing. (2020, June 17). Heart attack (Myocardial infarction). Harvard
Health.
https://www.health.harvard.edu/a_to_z/heart-attack-myocardial-infarction-a-to-z
16.
Cardiovascular system (Links to an external
site.)
Taylor, T. (2020, July 29). Cardiovascular
system. Innerbody.
https://www.innerbody.com/image/cardov.html
17.
Circulatory shock (Links to an external
site.)
Vincent, J. L., & De Backer, D. (2013, October 31). Circulatory
shock. New England Journal of
Medicine. https://www.nejm.org/doi/full/10.1056/NEJMra1208943

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