Can you please provide a response to this 2-part discussion (file included)? APA w/ reference. Thanks!
J.D. is at risk of developing iron deficiency anemia due to several factors. She has experienced intermenstrual bleeding and menorrhagia for the past two months, which can result in iron depletion (Nugraheni et al., 2023). Her recent childbirth, only four months ago, and multiple pregnancies may have caused further iron loss through postpartum bleeding. In addition to these factors, J.D.'s chronic knee pain necessitates long-term use of ibuprofen, and she takes hypertension medications that include a diuretic; both contribute to her risk of iron deficiency. Collectively, these circumstances heighten her vulnerability to developing anemia.
J.D. experiences constipation and dehydration, possibly related to her medication use and underlying health issues. Consistent usage of ibuprofen can irritate the digestive system lining, leading to constipation. Additionally, J.D. takes omeprazole as a precaution against gastrointestinal bleeding caused by ibuprofen. However, this medication's ability to decrease stomach acid production may hinder water absorption and nutrient intake, potentially resulting in dehydration.
Critical for red blood cell creation are vitamin B12 and folic acid (Nugraheni et al., 2023). Their absence can trigger anemia. Red blood cell maturation and DNA composition benefit from Vitamin B12, but insufficiency may result in megaloblastic anemia featuring more giant, undeveloped cells. Necessary equally is folic acid, which aids DNA compilation and cellular division; its deficiency might lead to the same type of anemic condition characterized by larger-than-usual red blood cells.
Common symptoms of anemia include fatigue, weakness, and paleness due to reduced oxygen-carrying capacity in the blood. J.D. also experiences occasional bleeding between periods and heavy menstrual bleeding. Her frequent urination may be related to fluid imbalances, while mild incontinence could result from weakened pelvic muscles caused by anemia.
Healthcare providers may notice signs such as pale conjunctiva and mucous membranes, brittle nails and nail beds, a pale tongue, angular stomatitis (inflammation at mouth corners), and tachycardia (rapid heart rate) due to decreased oxygen delivery. A systolic flow murmur could also be heard from increased blood flow in dilated cardiac chambers.
Based on the results and presentation, it is recommended to supplement with iron for iron deficiency, investigate underlying causes of menorrhagia, consider alternative pain management options instead of ibuprofen, effectively monitor and manage hypertension, and provide nutrition education to support iron levels. Addressing both the anemia and contributing factors is essential for overall health.
Cardiovascular
Behaviors like smoking, poor diet, stagnant lifestyle, and heavy drinking that heighten the risk of coronary artery disease are alterable factors known as modifiable risk factors. Conversely, there are certain aspects such as age group, gender (higher predisposition in males), a family history tracking CAD, and genetic proneness adding to one's vulnerability towards said disorder, which cannot be altered and referred to as non-modifiable risk factors.
Mr W.G.'s electrocardiogram might depict particular alterations signifying an acute cardiac incident, including ST-segment elevation often linked with heart attack occurrences (Wallen et al., 2022). His persistent chest discomfort and ineffective relief from nitroglycerin strongly indicate his suffering from an emergent coronary situation that necessitates immediate hospital attention.
To accurately diagnose sudden-onset myocardial infarction or AMI - medical parlance for what is known commonly as 'heart attack,' doctors use a specific test called troponin assay to detect the existence of this protein strain – troponins within your blood circulation system (Mueller et al., 2022). A heightened presence hints at considerable damage inflicted on heart muscles, thus serving as a significant clinical diagnostic tool.
The raised body temperature that Mr. W.G. is experiencing likely originates from the inflammatory processes initiated by his myocardial infarction. This inflammation spurs immune system components, such as cytokines, which may induce a fever-like condition. Such symptoms might linger for several days post-heart attack.
Mr. W.G. experienced pain during myocardial infarction due to inadequate blood flow (ischemia) towards the cardiac muscles. This created unbearable pain by releasing compounds like adenosine and bradykinin that stimulate nerve endings, leading to discomfort around his chest area. Moreover, the ischemic state harmed cells and interrupted oxygen-rich circulation within the heart's musculature, slowly resulting in cell death and aggravating physical and emotional trauma on Mr. W.G. during this unfortunate occurrence.
References
Mueller, C., Twerenbold, R., & Reichlin, T. (2019). Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. Clinical chemistry, 65(3), 490-491.
Nugraheni, A. I., Wijayanti, K. R. D., & Manuaba, I. A. I. M. (2023). Severe Megaloblastic Anemia & Thrombocytopenia in Pregnancy: A Case Report. European Journal of Medical and Health Sciences, 5(2), 14-19.
Wallen, M., Kupsaw, G. E., & Ganti, L. (2022). A true case of a broken heart with Takotsubo cardiomyopathy. Cureus, 14(1).
