Pancytopenia a type of anemia that can be define as a decrease in three blood cell types, red blood cells, white blood cells, and platelets. Prior to my pathophysiology course, I had never actually came across a patient in practice with this diagnosis. However, a few weeks ago, as I was receiving report from the off going nurse, she informed me my patient had recently been released from University of Hospital (U of L) with similar symptoms and had been treated for Helicobacter pylori infection. After receiving the discharge summary from U of L, it was discovered the patient had additionally been diagnosed with pancytopenia. My attention was immediately perked up as we had recently did a case study with the diagnosis of pancytopenia. It was a busy 12hrs and I had little time to study her case to the extent I would have like to. However, I will share some of the signs and symptoms discovered during my assessment. The patient was a 34 year old female that was admitted during the night shift to the Transitional Care Unit (TCU) through the emergency department for nausea and vomiting times three (3) days. In the emergency department, she was treated with fluid resuscitation of Normal …show more content…
The patient had underwent EGD with low platelet counts and her laboratory could have been repeated to see if treatment had been beneficial. In addition, the patient remain weak and could only maintain a small portion of the bland diet ordered. Pancytopenia is symptomatic diagnosis and should be follow up for causative factors. Due to the fact the patient was noncompliant with the initial treatment prescribed, I was not convinced the patient would follow up with U of L as instructed. As I had stated in the introduction, the 12hr day was a busy shift. I wish I could have been more intimate with the case and less task oriented perhaps I could have built a better case in keeping or
HPI: MR is a 70 y.o. male patient who presents to ER with constant, dull and RUQ abdominal pain onset yesterday that irradiate to the back of right shoulder. Client also c/o nauseas, vomiting and black stool x2 this morning. He reports that currently resides in an ALF; they called the ambulance after his second episodes of black stool. Pt reports he drank Pepto-Bismol yesterday evening without relief. Pt states that he never experienced similar symptoms in the past. Denies any CP, emesis, hematochezia or any other associated symptoms at this time. Client was found with past history gallbladder problems years ago.
-The patient was having pitting edema and inspiratory rales because the increase of sodium caused an increase of fluid in the vascular system and lungs.
The patient is a 45 year old male who was in a car accident that
Thrombocytopenia affects 6% to 10% of all pregnant women and, other than anemia, is the most common hematologic disorder in pregnancy (McCrae, 2010). The blood consists of three main ingredients: red blood cells, white blood cells, and platelets. Each plays an essential function to provide the human body with elements and protects the body against any exterior viral and infection. Platelets are responsible to help blood to clot. The deficiency or disorder of platelets lead to disease called Thrombocytopenia. This issue is diagnosed when platelets are less than 150,000 platelets per microliter of blood (Erkurt, et. al, 2012).
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
Bowers, L., Allan, T., Simpson, A., Nijman, H., & Warren, J. (2007). Adverse Incidents, Patient
There are many causes of anemia in the body. Some factors include genetics and deficiencies in the diet. Ms. A claims that for the past 10 – 12 years menorrhagia and dysmenorrheal have been a problem for her. Menorrhagia is abnormal and heavy menstrual bleeding during menstruation (Mayoclinic, 2013). Menorrhagia can deplete iron levels in the blood and increase the risk of an individual to have iron deficiency anemia. This is the cause of Ms. A’s anemia. Moreover, Ms. A says that she constantly takes aspirin especially in the summer to prevent stiffness in the joints. Aspirin affects and hinders the production of red blood cells (Mayoclinic, 2013). From the description of anemia given above, the lack of red blood cells, leads to low levels of iron and therefore low levels of hemoglobin which in turn affects the transportation of oxygen and thereby causing shortness of breath. Ms. A’s initial complains of shortness of breath and fatigue is the reason why she went to see the physician.
Toby-Finn, a 21 year-old Caucasian gentleman, is presented to the Emergency Department with a chief complaint of severe abdominal pain. Toby-Finn, who is a full time college student was just discharged three days ago from the Medical Surgical Unit status post laparoscopy appendectomy. Upon arrival to the Emergency Department, Toby-Finn has a computed tomography of the abdomen, and he is diagnosed with Ischemic Necrosis of Small Bowel, and required to go under another abdominal surgery. Toby-Finn was given a total of four milligrams of Morphine Sulfate intravenously, five milligrams of Reglan intravenously, and one liter of Normal Saline intravenously in the Emergency Department. The admitting physician, Dr. Sophie had contacted the surgeon, Dr. Scarlett for emergency surgery. In the meantime, Dr.Sophie had provided a written order for pain management to keep the patient comfortable.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
I was on my Monday evening shift and I was assigned for eight patients where seven of them were older and this teen named Mr.Govanni was with sickle cell anemia. When I took the handover from the dayshift nurse, I particularly noticed this patient from my assignment list because of his age and condition and at the same time the nurse who handed over the duty specifically told me that the teen boy was non-cooperative and also I saw it from the chart that the patient was getting the normal saline at 75cc/hr, CBC result morning( 6 am) showed HB-82g/dl, WBC 10.6. According to doctor’s order repeat CBC at 1600hr and if the HB is less than 80 transfuse two units of PRBC and lasix 40 mg in between the transfusion.
III. Imagine your best friend has just been diagnosed with leukemia, a disease requiring regular transfusions of platelets.
He is admitted to the ward with the chief complain of pain at right lower quadrant of the abdomen for 8 hours prior to his admission.
Patient profile: Heterosexual Muslim Woman who has been in the United Stated for three years. She came from Pakistan. She is 42 forty-two years old, from low socioeconomic standing, English language barrier, and is Muslim rituals and practices. She came to emergency department with her husband due to shortness of breathing, high fever, severe cough. She was dignosed with new onset of pneumonia and currently on antibiotic. she also has history of Vitamin D deficiencies and diabetes mellitus type II. She admitted to medical-surgical floor for observation...
Polycythaemia is a blood disorder defined as an increase in blood erythrocyte concentration. Absolute polycythaemia is where this increase is caused by greater erythrocyte production, determined by measuring the haematocrit level, with one study showing that 83% of sufferers have a haematocrit level of >55%. This should not be confused with relative polycythaemia, caused by a decrease in blood plasma volume often secondary to hypertension. Interestingly, those affected tend to also have increased blood platelet and white cell concentrations, which correlates well with the notion that the disease is caused by a genetic defect in the haematopoietic stem cell population within the bone marrow. Studies have shown the median age of onset to be 60, although a Mayo Clinic study in Olmstead County, Minnesota showed it to be slightly higher, at between 70 and 79 years, with men affected more than women – though the reason behind the gender inequality is currently unknown. In addition, its prevalence within the US is thought to be in the region of 50/100,000. Furthermore, it has long been known that Finnish skier and seven time Olympic champion Eero Mantyranta suffered from the disease, and it is often stated that his success, at least in part, can be put down to his polycythaemia – indeed experiments have shown that it can increase the blood oxygen carrying capacity by up to 50%, an undeniable asset to any endurance athlete. However, the disease can also prove fatal in many cases because the thickened blood increases the probability of clot formation, giving deep vein thrombosis and potentially pulmonary embolus. It is this double edged nature of polycythaemia that first took ...
The patient has also been suffering from frequent fevers in the past two months. He has also suffered from frequent headaches but has always taken painkillers (Bloland & Williams, 2003, p. 58). On fevers, the patient has frequently visited a local health clinic that has never done any diagnosis but has given medication, which reduces the fever.