Mr. Fitts, a 72-year-old male whose wife died six months ago, is brought to the health care provider by his daughter because he is not eating much and has been lethargic and sleeping a lot. He has a history of hyperlipidemia for which he takes niacin/lovastatin 500/20 mg PO daily at bedtime.Subjective DataHas been unusually tired for the past couple of monthsIs frequently short of breath and sometimes feels like his ‘heart is pounding’Has lost weight because his wife always used to cook for him and he doesn’t cook for himselfDescribes a typical daily meal as coffee and a donut for breakfast, a hot dog and lemonade for lunch, and a jelly sandwich on white bread and coffee for supperObjective DataPhysical ExaminationBlood pressure 118/72, pulse 98, temperature 98.2° F, respirations 16Oxygen saturation 92% on room airHeight 5’6”, weight 135 lbs, BMI 21.7 kg/m2S1 and S2 auscultated and regularBilateral radial pulses +3 and regularLungs clear bilaterallyDiagnostic StudiesRBC 3,300,000/µLHemoglobin 8.3 g/dLHematocrit 24%MCV 73 fLMCH 23 pgWBC 9,100/µLPlatelets 250,000/µLIron 28 mcg/dLFerritin 14 ng/mLCobalamin 600 pg/mLFolate10 ng/mLQuestion 1Interpret Mr. Fitts’s laboratory results. Interpretation means to tell me what is abnormal and what is normal. If the lab is abnormal, please tell me what it can be attributed to.Question 2Based on the laboratory data and assessment findings, the health care provider diagnoses Mr. Fitts with iron deficiency anemia. What clinical manifestations of iron deficiency anemia does Mr. Fitts have?Question 3Explain iron deficiency anemia and identify the probable cause of D.G’s anemia.Question 4How is iron deficiency anemia treated?Question 5Identify dietary iron sources to include in Mr. Fitts’s teaching.Question 6What are important points to include when teaching patients taking oral iron supplements? Please be specific as to what to take them with and what are the side effects.Question 7What evaluative parameters could you use to determine whether Mr. Fitts’s anemia is resolving? In other words how are you going to know he is getting better and please be specific to labs and potential assessment findings.
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