Published Nov 25, 2007
datamini
13 Posts
The patient has been passing melena stool for the pass 3 months.He has laceration on his forehead, fainted, looking pale and tired and the corners of his mouth cracked. He also complained of sore throat. Haemoglobin level is 8.1g/dl. Iron & Ferritin level were low. Doctor has ordered ferrous fumarate 200mgm OM, 1U packed cells to be transfused.The patient also need to go for gastroscopy & colonoscopy.
I need to identify the haematological condition he is having.
Am I right?:
He is either having nutritional anemia or iron deficiency anemia.
Excessive iron loss is either due to bleeding because of the laceration,
or because he may have occult blood loss from slowly bleeding peptic ulcer, GI inflammation, hemorrhoids & cancer, that's why doctor has ordered him to go for gastroscopy and colonscopy.
I don't understand what is ferritin for.
Ferrous fumarate is to replace iron loss.
1unit packed cells is to replace the blood loss.
jmgrn65, RN
1,344 Posts
Most likely a long term bleed peptic ulcer or such. iron levels will drop with a long term bleed. ( I had heavy periods for years my iron was only 4) I don't seriously the laceration on his forehead has anything to do with his dx. Good Luck
ps your on the right track, good critical thinking.
Do u know what haematological condition he is having? And by the way what is Ferritin for?
Daytonite, BSN, RN
1 Article; 14,604 Posts
Any time you are looking to come up with a diagnosis, any diagnosis, you must first look at the signs and symptoms that patient is having. A diagnosis is the decision or opinion you make after the process of examination or investigation of the facts. In the medical and nursing world that means after you do an assessment of the patient and an analysis of the assessment you then make your decision. This is the information you were given:
The orders that were given were:
Now, having gone through the assessment information and analyzed it, what would you say this patient's haematological (pertaining to the blood or blood forming organs) condition is?
I would say that based upon the fact that the patient has had three months of melena he has some kind of GI bleeding going on and that blood loss anemia is what is going on. All the other symptoms are indications of the anemia which is the result of the blood loss. This patient probably has a malignant tumor or a gastric/duodenal ulcer, both of which cause bleeding and inflammation and will lead to all the other symptoms the patient is having if not treated.
Sorry. And thanks for all ur suggestions. I think I've type wrongly. He complained of "sore tongue" not "sore throat".
A sore tongue is not going to make a that big of a difference here! It is a symptom of his dehydration. This patient is having GI bleeding and loosing fluids because of it. You were asked to give a hematological diagnosis, not a metabolic diagnosis. Hematologically, this patient is having blood loss anemia. Metabolically he is dehydrated. However, you were not asking about his metabolic condition.
I think I understand what you mean. The patient is probably having GI or intestinal problem which causes bleeding. Thus he's passing melana stool. This causes blood loss and loss of fluid & electrolytes, which made the patient faint and have cracked mouth. The doctor ordered ferrous fumarate is to replace the blood loss. Gastroscopy and colonoscopy is to investigate for any abnormalities which cause melana stool.
Thank you Daytonite, you've been a great help:nurse: