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Roodelyne Petit.
This week I continue to learn how to conduct a well detailed physical examination with my preceptor. She emphasizes on the importance of collecting as much data as possible and how crucial details that can easily be overlooked be a principal diagnosis. I am also learning a little bit of the various cultures that we encounter in south Florida, the patient population in this clinic is mostly Hispanics and Haitians decent. Therefore, language and cultural barrier is a constant conversation in the office among staff and patients and daily challenge for a some of us.
Did you face any challenges, any success? If so, what were they?
As stated above one of my biggest challenges right now is the language barrier that exists between the provider and the patients. The clinic uses a program called “Certified Languages” to translate when a coworker or family member is not available. However, sometimes even that appears to be difficult because some Hispanic patients speak different dialect that even the translator sometimes has a hard time understanding or transmitted information accurately.
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and possible differential diagnosis.
This week I had the pleasure to care for a forty-seven-year-old woman who suffers from iron deficiency anemia. Iron deficiency anemia remains as a major threat to global health, and it is highly prevalent among women throughout their lives. Some females are particularly vulnerable to iron deficiency/iron deficiency anemia, including those with heavy menstrual bleeding and pregnant/postpartum women. Shubham et al. (2020) The patient came in complaining of generalized weakness, insomnia, inability to focus on tasks. Her nailbeds were noted to be very pale as was her general skin appearance. She denies any bleeding gums but admits that her periods have being lasting for close to two weeks at a time for the past nine months, however she does not have a monthly period. Given the fact that her body is going through menopause, my preceptor considers heavy bleeding as one of the differential diagnoses for the patient’s anemia.
Iron demands vary throughout a woman’s life. Women of reproductive age are at risk of absolute iron deficiency when iron supply from their diet is unable to meet the additional demand from menstrual blood loss.
What did you learn from this week’s clinical experience that can be beneficial for you as an advanced practice nurse?
Iron plays an integral role in a wide range of physiological functions, therefore, the health consequences of iron deficiency and iron deficiency anemia in women are extensive and potentially serious if left untreated. Mirza et al. (2018) Symptoms are often nonspecific but can include fatigue, irritability, hair loss, poor concentration, palpitations, and dizziness.
References
Means, R. T. (2020). Iron Deficiency and Iron Deficiency Anemia: Implications and Impact in Pregnancy, Fetal Development, and Early Childhood Parameters. Nutrients, 12(2), 447. https://doi.org/10.3390/nu12020447
Mirza, F. G., Abdul-Kadir, R., Breymann, C., Fraser, I. S., & Taher, A. (2018). Impact and management of iron deficiency and iron deficiency anemia in women’s health. Expert Review of Hematology, 11(9), 727–736. https://doi.org/10.1080/17474086.2018.1502081
Shubham, K., Anukiruthika, T., Dutta, S., Kashyap, A., Moses, J. A., & Anandharamakrishnan, C. (2020). Iron deficiency anemia: A comprehensive review on iron absorption,
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