NU 606 Week 6 Discussion 1 Question-Based Discussion TEAM A

Sample Answer

Describe the three stages of hemostasis.

Hemostasis is the process of stopping bleeding. This occurs in three steps. First, in response to injury, the blood vessel vasoconstricts or spasms. This decreases blood flow to the area.

Secondly, the thrombocytes adhere to underlying tissue at the site of the injury. Platelet plugs form during this step if the blood vessel is small.

Finally, the blood clotting/ coagulation mechanism is activated. A cascade reaction by the different clotting factors occurs here to form a blood clot (Hubert & Van Meter, 2018).

Explain the difference between the terms microcytic and megaloblastic. Identify one condition where each may occur. Microcytosis is when the red blood cell (RBC) size is smaller than the normal range. (Gotter, 2019).

A condition where this may occur is in iron-deficiency anemia. Megaloblastic anemia is a form of anemia where the red blood cells are larger than normal and there is a decrease in the number of those cells.

This is usually due to acquired deficiency in vitamin B12 or folic acid. Pernicious anemia is a type of megaloblastic anemia (Boston Children’s Hospital, 2017).

Compare the general effects of the general states of anemia and polycythemia in terms of hemoglobin level, hematocrit, general appearance, and possible complications.

There can be different causes for these conditions. Compare their general presentation, regardless of cause. In anemia, the hemoglobin and hematocrit levels are low. This can be due to a deficiency of a required nutrient such as iron, bone marrow function is impaired when there is excessive blood loss or a significant destruction of erythrocytes.

The general appearance in patients with anemia are fatigue, pallor, dyspnea, and tachycardia, and chest pain (if severe). Possible complications for anemia are oxygen deficit, congestive heart failure if there is a significant reduction in oxygen supply to the heart, and decreased regeneration of epithelial cells may cause inflammation and ulcers in the digestive tract.

Polycythemia is when there is an increased number of erythrocytes. This causes the hemoglobin and hematocrit levels to be high. Patients with polycythemia appear plethoric and cyanotic. These patients are overfilled with blood.

There is a bluish-red tone of the skin and mucosa. Patients may also experience pruritus, dyspnea, headaches, and visual disturbances. Possible complications from polycythemia are increased blood pressure, hepatomegaly, thrombosis and infarctions throughout the body, congestive heart failure, and joint pain if the uric acid levels are high (Hubert & Van Meter, 2018).

In patients with leukemia, the mouth and mucosa of the digestive tract are usually inflamed and ulcerated because of anemia, the effects of chemotherapy, and the presence of infections, such as candidiasis. Explain how this situation would affect food and fluid intake and list some possible subsequent effects on the patient with leukemia.

Food and fluid intake is limited in patients with leukemia who are experiencing an inflamed and ulcerated digestive tract, effects of chemotherapy, and the presence of infections such as candidiasis. This is because patients do not want to eat and drink if they do not feel well or know it will cause them pain and discomfort.

This can lead to dehydration, weight loss, fatigue, fever, kidney stones, as well as an overall impaired ability to get better. The body requires hydration and nutrients to function, and if the body is deprived of that, it cannot do its intended job.

References

• Gotter, A. (2019). Everything You Need to Know About Microcytic Anemia. Healthline. https //www.healthline.com/health/microcytic-anemia
  Hubert, R. J., & VanMeter, K. C. (2018). Pathophysiology Online for Gould’s Pathophysiology for the Health Professions (6th ed.). Elsevier.
  
• Megaloblastic Anemia | Boston Children’s Hospital. (2017). Megaloblastic Anemia. https //www.childrenshospital.org/conditions-and-treatments/conditions/m/megaloblastic-anemia