Allyson Medina April 30, 2011
Assignment: Case Study #1
The Case: A 47-year-old female presents to a family practice clinic complaining of fatigue. When obtaining initial subjective data, the client admits to not eating red meat and shares that she is a member of the Seventh Day Adventist Church. She comments that her menses have been irregular with heavy flow over the course of the past six months. On Physical examination, her conjunctiva and mucous membranes are pale. Diagnostic complete blood count is obtained and her hematocrit is 24% and hemoglobin is 8g/dL.
1. Describe how you would assess the patient for health practices and beliefs that are outside of the biomedical and scientific model.
I would
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Yes, her diet could have caused her to be iron deficient, but there are numerous other possible causative agents. If her diet is to blame, then her diet would need to be adjusted – while respecting her religious beliefs. One could ask the patient if her diet could be altered to include the foods that she has omitted, as the Seventh-Day Adventist Church supports doing what’s best for one’s health, including eating red meats and such medical interventions as blood transfusions (James, 2005).
Besides the patient’s diet, a number of other problems can cause a low H/H resulting in pale conjunctiva and mucous membranes. She claims to have lost more blood recently due to changes in her menses, and although this could be the reason she is loosing blood, there are again, numerous other possibilities. I would have to ask the patient numerous questions from here…
Have you ever had black or tarry looking stools?
How about any stomach pain?
Have you ever been told that you have an ulcer?
Have you ever had a colonoscopy or endoscopy – where they take a camera and look through your mouth down into your stomach; or a camera that goes in your rectum that looks through your bowel and intestines?
What is your family medical history?
3. Identify any age or socioeconomic considerations.
At 47 years of age, women start to enter the time known as perimenopause. Bleeding heavier with irregular periods is typical for this time.
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A 79-year-old female present with her daughter for ongoing fatigue also noted to have lost 5 pounds over past 6 months. No night sweats or fevers. Pertinent past medical history includes severe, generalized osteoarthritis, hypertension, type 2 diabetes mellitus and depression. She is taking the following medications: acetaminophen 650mg every eight hours, Lyrica 75 mg twice daily; alendronate 70 mg once weekly, valsartan 320 mg once daily, fluoxetine 40mg once daily and insulin glargine 20 units once daily. Your exam reveals slight pale conjunctivae, a 2/6 systolic ejection murmur and generalized arthritic joints in her extremities. A point of care test results in a hemoglobin of 10.2 g/dL. Complete blood cell count is done; results
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Situation: The client is a 77 – year – old widow who relies on her late husband’s savings for all her expenses. Over the past few years, she has eaten less and less meat because of her financial situation and the trouble of preparing a meal “just for me”. She also has medicines to buy for the treatment of hypertension and arthritis. Over the past 2 to 3 months, she has felt increasingly tired, despite sleeping well at night. When she goes to the clinic, the doctor orders blood work. The lab results are as follows: WBC 7.6 thou/cmm, Hct 27.3%, Hgb 8.3 mg/dl, platelets 151 thou/cmm. RBC indices are mean corpuscular volume 65 cmm, mean corpuscular hemoglobin 31.6 pg, MCH concentration 35.1%, red cell distribution width
The key issue faced by Impcorp Foods is that the existing accounting system is time-consuming and error-prone. It blocks the firm achieving its “Profitable Growth” strategy. There are two ways to deal with the problem: improve current system or buy the new ERP system. Compared to the existing system, which could not meet the industry standards and takes a lot of time, the advantages of the new ERP system will be shown. First, it meets the suppliers’ and the industry requirements. Secondly, the financial benefits outweigh the costs in a long run. Finally, employees seem positive about the new ERP system. Therefore, I recommend use the proposed ERP software and will explain further in the
Situation: The client is a 77 – year – old widow who relies on her late husband’s savings for all her expenses. Over the past few years, she has eaten less and less meat because of her financial situation and the trouble of preparing a meal “just for me”. She also has medicines to buy for the treatment of hypertension and arthritis. Over the past 2 to 3 months, she has felt increasingly tired, despite sleeping well at night. When she goes to the clinic, the doctor orders blood work. The lab results are as follows: WBC 7.6 thou/cmm, Hct 27.3%, Hgb 8.3 mg/dl, platelets 151 thou/cmm. RBC indices are mean corpuscular volume 65 cmm, mean corpuscular hemoglobin 31.6 pg, MCH concentration 35.1%, red cell distribution width