Clinical Scenario 3: Menorrhagia, Anemia, and Iron Deficiency Anemia

This clinical scenario discusses the causes and symptoms of menorrhagia, anemia, and iron deficiency anemia. It also provides nursing diagnoses and interventions for the patient. The patient experiences fatigue, shortness of breath, and petechiae. The diagnosis includes impaired skin integrity and ineffective tissue perfusion. The treatment includes antihistamines and transfusing blood to increase hemoglobin levels.

Running head: CLINICAL SCENARIO 3 1
Clinical Scenario 3
(Author’s name)
(Institutional Affiliation)

CLINICAL SCENARIO 3 2
1. Menorrhagia - This is when there is a prolonged heavy bleeding that occurs during the
normal menstrual cycle of a woman.
Causes-hormonal imbalances ("Iron Deficiency Anemia (IDA): A Review", 2016)
2. Anemia- This is a condition where a person has a lower number of red blood cells or
level of hemoglobin than normal (Townsend, Cheung, Horne & Ransford, 2016)
3. Iron deficiency anemia- This is due to the fact that the will try to make more red blood
cells and hemoglobin using the iron stored in the body hence leading to iron deficiency
("Iron Deficiency Anemia (IDA): A Review", 2016).
4. The reason for tiredness and shortness of breath is due to the fact that Fiona has no
enough red blood cells to carry oxygen around the body. Oxygen is required for
metabolisms and production of energy in the body(Auerbach & Adamson, 2015).
5. Petechiae are red or purple spots on the skin that are usually as a result of bleeding into
the skin. Fiona has a type of anemia that contains fewer platelets hence the bruising
(Townsend, Cheung, Horne & Ransford, 2016). This is due to the fact that her blood does
not contain iron-rich proteins thus the level of hemoglobin and platelets should be tested
to determine the coagulation process. Another disease process such as anaphylaxis should
also be tested(Auerbach & Adamson, 2015).
6. Complete blood count and hemoglobin level. Normal hemoglobin level ranges between
13 to 18 in men and 12 to 16 in women grams per deciliter ("Iron Deficiency Anemia
(IDA): A Review", 2016).
7. Increase heart rate and respiration rates are due to the fact that there is low oxygen
concentration in the body due to less hemoglobin. The body responds to an extent that

CLINICAL SCENARIO 3 3
more respiration is needed to increase oxygen intake and more heart rates to distribute the
little oxygen available to all parts of the body(Auerbach & Adamson, 2015).
8. Yes. Excessive glucose can damage the nerves that send a signal to kidney hormones
which trigger production of red blood cells (Townsend, Cheung, Horne & Ransford,
2016).
9. Leukemia is a malignant of blood stem cells including the bone marrow and the
lymphatic system ("Iron Deficiency Anemia (IDA): A Review", 2016).
10. Hodgkin disease is cancer of the lymphocytes. Hodgkin’s lymphoma usually has reed
Sternberg cells but non Hodgkin does not have when examined under a
microscope(Auerbach & Adamson, 2015).
11. Multiple myelomas is type of cancer that forms in plasma cells of the white blood cells.
12. Thrombocytopenia is a condition where the body has low platelet count. This can cause
severe internal bleeding especially when the protein count is below 10, 000 platelets per
microliter. (Auerbach & Adamson, 2015)
13.
Nursing diagnosis /problem Goals Interventions
Fatigue related to decreased
Hemoglobin levels as
evidenced by patients
complain of feeling tired and
having short of breaths
The client will verbalize that
she have a reduced fatigue
and report increased energy
and desire to go to the gym
1. Monitor hemoglobin
and blood cells levels
2. Instruct patient about
medication that might
stimulate red blood
cell production
Impaired skin integrity The patient will demonstrate 1. Educate Fiona on the

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related to broken skin
capillaries as evidenced by
the presence of bruises.
reduced bruises in a period
of one day
best nutrition,
hydration, and
methods to maintain
tissue integrity
2. Provide tissue care as
needed
Ineffective tissue perfusion
related to low hemoglobin
levels as evidenced by
increases respiration rates up
to 22 beats per minute
The patient will demonstrate
effective tissue perfusion and
able to breathe normally
1. Provide with oxygen
therapy
2. Transfuse blood to
increase hemoglobin
levels.
(Auerbach & Adamson, 2015)
14. Anaphylaxis is a rapid severe allergic reaction that affects several body systems due to
the release of cytokines and inflammatory mediators from basophils and due to an
immunologic reaction. The immunoglobulin E binds to antigen activating the receptors of
basophils and mast cells. This leads to the release of histamines which increases leakage
of fluids from capillaries, contraction of bronchial smooth muscles and triggers
vasodilation (Mayo Clinic 2018).
15. Antihistamines through intravenous injection.
16. C
17. D
18. B

CLINICAL SCENARIO 3 5
19. E
20. C
21. D
22. C
23. B
24. B
25. E
References
Auerbach, M., & Adamson, J. (2015). How we diagnose and treat iron deficiency
anemia. American Journal Of Hematology, 91(1), 31-38.
Mayo Clinic (2018)Anaphylaxis - Diagnosis and treatment - Mayo Clinic. Retrieved from
https://www.mayoclinic.org/diseases-conditons/anaphylaxis/diagnosis-treatment/drc-
Iron Deficiency Anemia (IDA): A Review. (2016). International Journal Of Science And
Research (IJSR), 5(4), 1999-2003.
Townsend, S., Cheung, D., Horne, E., & Ransford, R. (2016). A 5-Year Follow-Up of Study
Patients With Asymptomatic Iron-Deficiency Anemia Using a Nurse-Led
Pathway. Gastroenterology Nursing, 39(6), 466-471.