Hematology Case Study Essay Assignment

Hematology Case Study Essay Assignment

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Healthcare providers schedule follow-up clinics for patients whose health conditions should be monitored. The case study is about Ginny, a 65yo female who visits the primary care clinic for a scheduled appointment. The client has a history of decreased kidney function and congestive heart failure. Ginny appeared slightly pale and unusually tired during today’s clinical visit. Physical examination results rule out worsening existing health conditions, including heart failure and kidney disease or acute illness. As a result, the healthcare provider orders Ginny’s complete blood count (CBC)Hematology Case Study Essay Assignment. Her hemoglobin and hematocrit were 9.5 g/dL and 29%, respectively. The client’s previous hemoglobin levels ranged between 11 and 13 g/dL. This discussion includes the client’s appropriate diagnostics, blood transfusion, treatment plan medication, erythropoietic agent considerations, and recommendations for follow-up care.

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The Client’s Pertinent Diagnostics

The client appeared slightly pale and unusually tired during today’s clinical visit. According to Arzoo et al. (2022), pale skin colour and fatigue are significant symptoms of anaemia. Consequently, the client ordered CBC, the most appropriate diagnostic for patients with suspected anaemia, determined through haemoglobin and hematocrit levels. The average hematocrit level in women ranges from 36% to 44% (Harper et al., 2021). Hematocrit levels below the average in women imply that an individual has few red blood cells, hence anaemic (Harper et al., 2021). Based on the lab result, the client’s hematocrit level was 29%, below the average; therefore, she has anaemia. On the other hand, the average haemoglobin level in women ranges from 12 to 16 g/dl (Lim et al., 2020)Hematology Case Study Essay Assignment. The client’s haemoglobin during the visit was 9.5 g/dL, indicating anaemia. Therefore, CBC was the most appropriate diagnostic for this client.

Blood Transfusion

The client has anaemia based on health-related data collected during clinical assessment (Being slightly pale and unusually tired) and lab results, including low haemoglobin and hematocrit levels. Therefore, the healthcare provider should focus on managing the client’s condition to prevent further anaemia-related health complications, including tachycardia or heart failure. However, blood transfusion is not the most appropriate treatment therapy. According to Amin et al. (2019), blood transfusion is recommended in patients with a haemoglobin level below 7 g/dL. Ginny’s current haemoglobin level is 9g/dl; therefore does not require a blood transfusion. Additionally, blood transfusion is not recommended for this client due to potential safety issues, including infection transmission and iron overload (Aapro et al., 2019)Hematology Case Study Essay Assignment.

Treatment Plan Medication

Pharmacological treatment therapy should be used in managing the client’s condition. The client should be administered darbepoetin 0.45 µg/kg once weekly. This drug is preferred due to the efficacy of erythropoiesis-stimulating agents (ESAs) in managing anaemia in patients with chronic kidney disease (CKD) (Aapro et al., 2019). According to Aapro et al. (2019)Hematology Case Study Essay Assignment, clinicians should target Hb levels between 11 and 12 g/dL in anaemic CKD patients. Therefore, the client’s haemoglobin and hematocrit levels are expected to rise to a level ranging from 11 to 12 g/dl after taking the medication for 14 days.

Erythropoietic Agent Considerations

Erythropoiesis-stimulating agents (ESAs) have enhanced the treatment of anaemia in patients with chronic kidney disease. However, the FDA recommends that healthcare providers prescribe the lowest ESA dose to CKD patients to prevent potential transfusions (Aapro et al., 2019). Studies show that the FDA eliminated Hb targets, ranging from 10 to 12 g/dL in CDK and recommended the minimum ESA dose adequate for preventing transfusion due to safety concerns, including infection transmission (Aapro et al., 2019). Therefore, the client should be prescribed the lowest dosage of erythropoiesis-stimulating agents (ESAs) to reduce the risk of potential ESA-related adverse effects.

Recommendations for Follow-Up Care

The client should be advised to return to the clinic after four weeks. The healthcare provider will order CBC to evaluate her level. An increase in the client’s haemoglobin level by 1 g/dl after using darbepoetin 0.45 µg/kg once weekly indicates the efficacy of the current drug and dosage in managing her anaemia. Consequently, the client should continue with the current drug and dosage for the next four weeks and return to the clinic for review. However, the client’s current dosage should be maintained even if a 1 g/dl increase in haemoglobin level is not achieved after using darbepoetin 0.45 µg/kg once weekly for four weeks to prevent potential safety concerns. Hematology Case Study Essay Assignment

References

Aapro, M., Gascón, P., Patel, K., Rodgers, G. M., Fung, S., Arantes Jr, L. H., & Wish, J. (2019). Erythropoiesis-stimulating agents in the management of anaemia in chronic kidney disease or cancer: a historical perspective. Frontiers in pharmacology, 9, 1498.

Amin, R. M., DeMario, V. M., Best, M. J., Shafiq, B., Hasenboehler, E. A., Sterling, R. S., … & Khanuja, H. S. (2019). A restrictive haemoglobin transfusion threshold of less than 7 g/dL decreases blood utilization without compromising outcomes in patients with hip fractures. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 27(23), 887-894.

Arzoo, K., Andleep, J., & Khan, H. A. (2022). Prospective Deficiency Symptoms of Iron-Folate in Expecting Women, a Clinical Study. Pakistan Journal of Medical & Health Sciences, 16(05), 584-584.

Harper, J., O’Donnell, E., Khorashad, B. S., McDermott, H., & Whitcomb, G. L. (2021). How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation. British Journal of Sports Medicine, 55(15), 865–872.

Lim, W. H., Choi, E. K., Han, K. D., Lee, S. R., Cha, M. J., & Oh, S. (2020). Impact of haemoglobin levels and their dynamic changes on the risk of atrial fibrillation: a nationwide population-based study. Scientific Reports, 10(1), 1–8.

Introduction

This case study simulates a patient visit. Through a series of questions, you will identify a patient’s hematologic complaints, recommend and then interpret laboratory studies, and then utilize evidence-based clinical application tools and technology such as your Anemia Algorithm app to narrow down the differential diagnosis. At the end of the scenario, you will have the opportunity to enter your name and save a summary of your answers in an Adobe PDF document that you will submit in your course assignment. Hematology Case Study Essay Assignment

In this scenario, a patient will present with chief complaints of excessive fatigue and shortness of breath after activity.

Ginny’s Office Visit

Narrator: Your patient Ginny arrives for a scheduled appointment at your primary care clinic. Ginny is a 65-year-old woman who is one of your established patients. She has an history of congestive heart failure with decreased kidney function within the last year.

Doctor: Ginny, what prompted you to come see me today?

Ginny: I made this appointment because in the last week when I’ve taken my daily walk in the neighborhood, I’ve been feeling short of breath.

Doctor: I see.

Ginny: A friend in my neighborhood and I take brisk walks together to keep active. So it’s unusual for me to run out of breath like that. I’ve also felt so tired this week that I just wanted to sleep in instead of going out.

Narrator: You notice that she appears unusually tired and slightly pale. You gather additional history information from Ginny and conduct a physical examination, which rules out worsening heart failure, acute illness, and worsening kidney disease. You order labs for Ginny to get a complete blood count, CBC panel, and schedule her return visit to review the results. Hematology Case Study Essay Assignment

Vital Signs

You note the following vital signs for your records:

• Temperature: 98.7°F
• Heart rate: 92 bpm
• Respirations: 28 breaths per minute
• Blood pressure: 138/72

Continue

Ginny’s Return Visit

Your patient Ginny returns for her appointment to review her diagnostic results.

The complete blood count (CBC) results indicate that hemoglobin is 9.5 g/dL, which is a new finding, and the hematocrit is 29%. Previous hemoglobin levels have been 11 to 13 g/dL. You suspect that the low hemoglobin level is related to the decline in kidney function and begin to address treatment related to the condition.

Diagnostics

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Which test(s) should be performed to determine whether Ginny’s anemia is related to chronic disease or iron deficiency, and what would those results show? Hematology Case Study Essay Assignment

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Hematology Case Study Essay Assignment