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 Data

Has been unusually tired for the past couple of months

Is 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 himself

Describes 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 supper

Objective Data

Physical Examination

Blood pressure 118/72, pulse 98, temperature 98.2° F, respirations 16

Oxygen saturation 92% on room air

Height 5’6”, weight 135 lbs, BMI 21.7 kg/m2

S1 and S2 auscultated and regular

Bilateral radial pulses +3 and regular

Lungs clear bilaterally

Diagnostic Studies

RBC 3,300,000/µL

Hemoglobin 8.3 g/dL

Hematocrit 24%

MCV 73 fL

MCH 23 pg

WBC 9,100/µL

Platelets 250,000/µL

Iron 28 mcg/dL

Ferritin 14 ng/mL

Cobalamin 600 pg/mL

Folate10 ng/mL

Question 1

Interpret 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 2

Based 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 3

Explain iron deficiency anemia and identify the probable cause of D.G’s anemia.

Question 4

How is iron deficiency anemia treated?

Question 5

Identify dietary iron sources to include in Mr. Fitts’s teaching.

Question 6

What 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 7

What 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.