Case study 1

Case study 1

Ms. A. is an apparently healthy 26-year-old white woman. Since the beginning of the current golf season, Ms. A has noted increase shortness of breath and low levels of energy and enthusiasm. These symptoms seem worse during her menses. Today, while playing in a golf tournament, mountaineers course, she became lightheaded and was taken by had a golfing partner to immaculately cleaning. The attending physician’s notes indicated a temperature of 98°F, and elevated heart rate and respiratory rate, and low blood pressure. Ms. A states, “Menorrhagia and dysmenorrheal have been a problem for 10 to 12 years, and I take 1000 mg of aspirin every 3 to 4 hours for 6 days during menstruation.” During the summer months, while playing golf, she also takes aspirin to avoid “stiffness in my joints”.

Laboratory values are as follows:

Hemoglobin = 88 g/dl                                                                                                                    Hematocrit= 32%                                                                                                                              Erythrocyte count = 3.1×10/mm                                                                                                                 RBC smear showed microcytic and hypochromic cell                                                                         Reticulocyte count = 1.5%                                                                                                                       Other laboratory values we are within normal limits.

Question                                                                                                                                               Consider the circumstances and the preliminary workup, what type of anemia does Ms. A. most likely have? In an essay of 500-750 words, explain your answer and include rationale.

Case study 2

Mr. P A 70-year-old male with cardiomyopathy and congestive heart failure who has been hospitalized frequently to treat CHF symptoms. He has difficulty maintaining diet restrictions and managing his polypharmacy. He has 4+ pitting edema, moist crackles throughout lung fields, and labored breathing. He has no family other than his wife, who verbalizes sadness over his declining health and over her inability to get out of the house. She is overwhelmed with the stack of medical bills, as Mr. P always took care of the financial issues. Mr. P is despondent and asks why God has not taken.

Question 

Considering Mr. P’s condition and circumstance, write an essay of 500- 750 words that include the following:

• Describe your approach to care                                                                                                               
• Recommend a treatment plan                                                                                                               
• Describe a method for providing both the patient and family with education and explain your rationale.                                                                                                                                                
• Provide a teaching plan (avoiding using terminology that the patient and family may not understand).