From the case presented, it is clear that Ms. A is suffering from Iron Deficiency Anemia (IDA). Anemia is defined as a condition in which the number of red blood cells (RBC) or their capacity to carry oxygen is inadequate to meet the body needs of a person (Cheatham, 2000). Iron Deficiency Anemia is the most common and prevalent type of anemia globally, affecting approximately 50% of pregnant women, 20% of women, and 3% of men. IDA is a condition in which the amount of red cells in the blood in reduced due to the inadequate iron. As the name suggests, it is caused by inadequate iron in the blood stream. Without sufficient iron, the body cannot produce enough hemoglobin to enable the red blood cells to carry oxygen and, as a result, a person with IDA feels tired and without enough breath. The major risk factors that contribute to IDA include heavy periods that result to excessive blood loss, donation of too much blood, low body temperature, poor diet, as well as internal bleeding. Symptoms of Iron Deficiency Anemia include low blood pressure, paleness, rapid heartbeat, weakness, reduced appetite, shortness of breath, headache, brittle nails etc (Cheatham, 2000).
It is apparent that Ms. A is suffering from Iron Deficiency Anemia because the symptoms mentioned in the case such as dizziness, shortness of breath, low blood pressure, increased heart rate etc. are all symptoms of DIA. In addition, it is also mentioned that she has been suffering from menorrhagia and dysmenorrheal for the past 10-12 years. Menorrhagia is a medical term that refers to a regular menstrual period in which the bleeding is abnormally heavy and prolonged. Dysmenorrheal, on the other hand, refers to the discomfort or pain associated with menses (Noorhasan & Weiss, 2010). The fact that Ms. A takes 1,000 mg of aspirin every 3 to 4 hours daily all through her six-day period shows that her periods are painful enough to keep her from performing her daily duties and, therefore, she has to take a pain reliever. In addition, a normal menstrual period takes an average of five days, and Ms. A’s periods lasted six days, an indication that she looses more blood. Blood contains iron within the RBC and when it is lost excessively, iron is also lost. Excessive blood lost during heavy periods is a risk factor to getting Iron Deficiency Anemia (Cheatham, 2000). In addition, the excessive amount of aspirin that Ms. A takes during her menses to relieve her of dysmenorrheal may also have been a contributor to Iron Deficiency Anemia. This is because too much intake aspirin can lead to unnoticed gastrointestinal bleeding, which may result in IDA (Cheatham, 2000). That is why I am convinced that she is suffering from IDA.
The lab results showed that her temperature was 98 degrees Fahrenheit, which is below the normal body temperature of 98.6 degrees Fahrenheit. Iron plays a vital role in the regulation of body temperature and, therefore, when it is too little, the body cannot maintain its normal temp, and as a result, a person with IDA always feels cold. This explains the low body temperature of Ms. A. Besides, the laboratory results showed that her Hemoglobin was 8 g/dl, Hematocrit = 32% Erythrocyte count = 3.1 x 10/mm. RBC smear showed microcytic and hypochromic cells Reticulocyte count = 1.5%. The normal reticulocyte count is between 0.5% and 1.5%; therefore, Ms. A’s Reticulocyte count was normal. However, her hemoglobin level of 8 g/dl was far below the normal hemoglobin range of a woman, which is between 12.0 and 15.5 g/dl. Lower hemoglobin levels than normal is an indication of deficiency of iron in the blood, which causes Iron Deficiency Anemia. In addition, her Hematocrit level of 32% is also below the normal level of a woman, which is between 34.9% and 44.5%. Hematocrit is the percentage of the volume of blood made up by the RBC (Cheatham, 2000). Low Hematocrit levels indicate insufficient amount of red cells in the blood. All these evidences point to the fact that Ms. A. suffers from Iron Deficiency Anemia.
Cardiomyopathy is a condition in which the muscles of the heart are weakened (Wexler, Elton, Pleister, & Feldman, 2009). Congestive heart failure, on the other hand, is a condition that causes the heart’s failure to pump blood efficiently and, consequently, fluids build up in different parts of the body such as the lungs, feet, ankles etc. Treating cardiomyopathy and congestive heart failure involves a combination of medicines such as beta blockers, diuretics, digoxin, nitrates, anticoagulants etc. Coronary bypass surgery can also be recommended by the doctor to treat congestive heart failure in the case where the coronary arteries are very narrow. Surgical implantation of a pacemaker on Mr. P is another option to help in the treatment of a slow heart rate (Wexler, Elton, Pleister, & Feldman, 2009). In severe cases where all treatment options have failed, Mr. P will have to undergo a heart transplant. It is important that the patient and his family know that the above diseases are incurable and the available treatment options are only aimed at controlling the symptoms of the diseases in order to enhance the quality of life of Mr. P. We have been told that Mr. P has problems taking his numerous drugs. The patient should know that his condition is serious and if he does not take his drugs as prescribed by the doctor, he will certainly die. It is therefore up to him to choose to live by ensuring that he follows the doctor’s orders. The wife should also ensure that he takes his drugs correctly.
From the case, it is clear that Mr. P does not have the support of his family except from his wife. The family of the patient should know that their support and encouragement are very vital to the recovery of the patient and, therefore, if they do not want him to die, they should be there for him. The patient’s hopelessness may have been caused by the lack of support from his family. Mr. P should be aware that stress of any kind is not good for his condition and, therefore, he should take it upon himself to ignore things that are bound to stress him up (Maron & Salberg, 2008). The patient has problems checking his diet, as consequently, it seems he is overweight since he cannot get out of the house. Considering Mr. P’s age of 76, he cannot engage in strenuous exercises but he should do mild exercises such as walking, jogging etc. to help to improve the functioning of his heart, reduce the build up of fluid in his legs that is causing his edema, as well as to improve his breathing problems. Finally, Mr. P should try to maintain a healthy diet that is low in salts, sugars and fats, but rich in vegetables and fruits in order to boost his overall immunity.