NR 507 Week 2 – Disease Process Presentation Assignment – PART 1
Anemia is a condition in which the body does not have the proper amount of red blood cells to carry hemoglobin throughout the body. There are many different reasons as to why one might have the diagnosis of Anemia.
Etiology and Risk Factors
Iron deficiency anemia (IDA) occurs when there is not enough iron absorbed from one’s diet. These individuals either do not consume enough iron or have excessive iron loss.
Iron deficiency can also occur from trauma, resulting in excessive blood loss. Some causes included:
Decrease iron intake due to poor intake (19%)
Impaired absorption of iron (41%)
Gastric surgery (10%)
Celiac disease (6%)
Pica
Gastrointestinal Bleed (56%)
Hemorrhoids (16%)
Pregnancy/lactation (6%)
Unknown cause (17%) (Epocrates, 2019)
Anyone can develop IDA at any time, but there are some who are more prone than others. Women are at a higher risk due to menstruation which is related to blood loss. Infants that are born with low birth weight or children going through a growth spurt are at risk for Anemia. Individuals who do not eat meat, vegetarians, do not consume enough iron in their diet due to not eating meat or other iron-rich foods (Mayo Clinic, 2016. People who are frequent blood donors are also at risk because they are suffering blood loss. Their bodies need time to recover from their loss to regenerate new red blood cells. They may need more time than required in between donations (Mayo Clinic, 2016).
Pernicious Anemia is caused by a lack of intrinsic factor that aids in the absorption of vitamin B12. There is an autoimmune response that causes the body to attack and destroy the parietal cells. These are the cells that are responsible for producing intrinsic factors (NHLBI, 2018). When the body is not able to produce intrinsic factors,s there is then a high chance of developing pernicious Anemia. The risk factors for having pernicious Anemia are as follows:
Malabsorption in the small intestine
Different diseases can interfere with vitamin B12
Celiac Disease
Crohn’s Disease
HIV
Medications prevent the absorption of vitamin B12
Antibiotics
Anti-seizure medications
Surgical removal of some or all of the stomach
Lack of vitamin B12 in one’s diet (NHLBI, 2018)
The most common type of people at risk for developing pernicious Anemia are those of Northern European and African descent. The elder generation carries a high risk due to a lack of stomach acid and intrinsic factors. The younger generation is at risk if there is a family history, had part or all of their stomach or small intestines removed, has an autoimmune disorder affecting the endocrine glands, or are a vegetarian (NHLBI, 2018).
NR 507 Week 2 – Disease Process Presentation Assignment – PART 1
Anemia and the Injury to the Body
Iron deficiency anemia is the most common type of Anemia. This type of Anemia can occur for different reasons. For example, whenever one losses blood, whether it be a cut or a traumatic injury, one loses iron as well. There are certain conditions or medications that can cause blood loss that leads to iron deficiency anemia. Some of these include bleeding in the gastrointestinal tract, rare genetic conditions, frequent blood donations/blood tests, heavy menstrual periods, injury or surgery, and urinary tract bleeding (NHLBI, 2018). Another reason for iron deficiency anemia is a lack of consumption of iron based on daily requirements. On the other hand, some individuals consume the daily recommended amount of iron and remain anemic. This is due to their body not being able to absorb iron. Individuals who have this form of Anemia could have an intestinal or digestive condition (celiac disease, inflammatory bowel disease, or Helicobacter pylori infection), a history of gastrointestinal surgery, or certain rare genetic conditions such as TMRPSS6 (NHLBI, 2018). This is a gene mutation that produces too much of a hormone called hepcidin that blocks the intestine from absorbing iron. Lastly, there are other medical conditions, such as end-stage kidney failure or inflammation from congestive heart failure or obesity, that can result in iron deficiency anemia. Individuals with end-stage kidney failure have blood loss due to dialysis. As previously mentioned, blood loss can be related to iron deficiency anemia. These individuals usually take medications such as proton pump inhibitors, anticoagulants, or blood thinners. These medications act as catch twenty-two because they need them, but proton pump inhibitors interfere with iron absorption while blood thinners increase the individual’s risk of gastrointestinal bleeding. Congestive heart failure or obesity can cause inflammation that can result in iron deficiency anemia (NHLBI, 2018). Iron deficiency anemia can be an easy fix, such as consuming more iron daily, or it can tend to be more difficult and need more in-depth solutions.
As mentioned earlier, pernicious Anemia is when the body is not able to make enough red blood cells because there is not enough vitamin B12 absorption occurring in the body (NHLBI, 2018). But how is there not enough B12 in one’s body? Individuals who are found to have pernicious Anemia are unable to absorb vitamin B12 from food sources. This is due to the fact that these individuals lack intrinsic factors. Intrinsic factor is a protein that is made in the stomach. When the stomach is not able to produce this protein, the result is a vitamin B12 deficiency (Toh, 2016). This is an autoimmune response from the individual’s immune system to make antibodies that unadvisedly attack and damage its own tissues and cells. Therefore, individuals with pernicious Anemia tend to make antibodies that attack the parietal cells. These cells are what line the stomach and are responsible for making intrinsic factors. Currently, there is no clear reason as to why this autoimmune response occurs. Due to the lack of intrinsic factors in the gastrointestinal system, the vitamin B12 that is present cannot be absorbed (NHLBI, 2018). When the body lacks significant amounts of vitamin B12, the body is unable to synthesize DNA properly. This then affects the production of red blood cells. Red blood cells are able to divide, but the nuclei will not mature. These types of red blood cells are called megaloblasts. These cells are destroyed when in the bone marrow and do not reach the circulatory system. However, some of the cells mature and become large red blood cells called macrocytes (The Editors of Encyclopaedia Britannica, 2019). When these cells reach the circulatory system, they function abnormally, resulting in other blood conditions.
NR 507 Week 2 – Disease Process Presentation Assignment – PART 1
Role of the Nurse Practitioner
As a Family Nurse practitioner, my role would first determine the type of Anemia prior to making a treatment plan. Some treatments would include seeing a dietician for diet modification, nutritional supplements, or medications. If there is a family history, it is important to closely monitor a patient (The Nurse Practitioner, 2005). Whenever the patient starts to show changes in laboratory work or physical, then intervention is needed. Some individuals may have Anemia due to an underlying disease. It is important to address this underlying disease while maintaining one’s Anemia.
Conclusion
Papers should end with a conclusion or summary. The assignment directions will specify which is required. It should be concise and contain little or no detail. No matter how much space is left on the page, the references always start on a separate page (insert a page break).
References
Epocrates. (2019). Iron Deficiency Anemia. Retrieved March 11, 2019, from https://online.epocrates.com/diseases/9424/Iron-deficiency-anemia/Etiology
Mayo Clinic. (2016, November 11). Iron deficiency anemia. Retrieved March 11, 2019, from https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms- causes/syc-20355034
National Heart, Lung, and Blood Institute. (2018). Pernicious Anemia. Retrieved March 7, 2019, from https://www.nhlbi.nih.gov/health-topics/pernicious-anemia
National Heart, Lung, and Blood Institute. (2018). Iron-Deficiency Anemia. Retrieved March 7, 2019, from https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia
The Editors of Encyclopaedia Britannica. (2019, January 11). Pernicious Anemia. Retrieved March 7, 2019, from https://www.britannica.com/science/pernicious-anemia
The Nurse Practitioner. (2005, December). Anemia. [Miscellaneous]. Retrieved March 11, 2019, from https://ovidsp.tx.ovid.com/sp-3.32.2a/ovidweb.cgi? &S=DGIDFPCFIIDDJHKENCDKADMCOHCFAA00&Link Set=S.sh.22|1|sl_10&Counter5=CRS_full_text|00006205-200512000-00010|ovft|ovftdb|ovfth
Toh, B. (2016). Pathophysiology and laboratory diagnosis of pernicious Anemia. Immunologic Research, 65(1), 326-330. Doi: 10.1007/s12026-016-8841-7
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Question 
Introduce the disease with a brief definition and description.
Discuss the risk factors and the connection to the etiology of the initial injury to the cell/tissue/organ.
Show the progression from the initial injury to the defect in the tissue, organ, and system functioning.
Discuss health care provider implications for the prevention of the disease.
Provide a summary slide that highlights the main points presented.
Reference slides and in-text citations depict references correctly cited according to APA.