Please respond to discussion below using current APA edition and 2 scholarly references. Must be at least 150 words.

Patient Evaluation

Q1:

The patient’s clinical manifestations of excessive fatigue, shortness of breath, paleness, and reduced hemoglobin levels from 13g/dL to 9.5g/dL are center side effects of anemia. However, because the patient has a history of chronic kidney illness, it is critical to evaluate whether the anemia is caused by chronic kidney disease or iron deficiency (Naeem et al., 2020). The most crucial phase in deciding is to do a Complete Blood Count (CBC), revealing the following iron-deficiency anemia results: low hemoglobin, hematocrit, ferritin, and total iron binding capacity (TIBC). If the CBC results show a non-diagnostic or higher-than-normal serum ferritin level with low TIBC levels, the anemia is caused by underlying chronic illnesses. The other tests to determine if the anemia is related to kidney disease are a peripheral blood smear and reticulocyte count.

Q2:

Blood transfusion should not be considered in this patient’s case, as a blood transfusion is a temporary solution for a severe case of anemia, and the patient has not showcased the severity that warrants this intervention (Babitt et al., 2021). Another reason a blood transfusion is not recommended is the probable association between the patient’s current anemia and her past kidney disease. Blood transfusion to the patient may result in iron overload, thus worsening damaged or injured renal cells.

Q3:

In this patient’s case, the pharmacological intervention’s core objective will be to elevate red blood cell production and improve her kidney functioning (Portoles et al., 2021). The patient shall be administered an iron supplement tablet to enhance red blood cell production. The recommended iron supplement, in this case, will be oral iron formulations and, more specifically, ferrous sulfate. Another medication of consideration in the patient’s case is erythropoiesis-stimulating agents (ESA), associated with the patient’s past kidney condition. The ESAs act by stimulating the bone marrow to actively produce more red blood cells to cover for the deficit arising from anemia. The patient shall be administered a combination of methoxy polyethylene glycol-epoetin beta (ESAs) and iron supplementation as a pharmacological option for the anemia.

Q4:

Notably, in treating the patient, erythropoiesis-stimulating agents (ESA) will be a critical medication alongside iron supplements (Portoles et al., 2021). When utilizing the medication, core considerations include contraindicating if the patient has severe allergic responses, seizure history, and hypersensitivity. Another consideration that the healthcare practitioner should consider in the patient’s care is periodically monitoring the patient’s blood pressure and utilizing anti-hypersensitive medications to keep the patient’s blood pressure in check. Other considerations include patient education not to operate a machine or drive when on the medication and not taking the drug alongside other medications.

Q5:

Follow-up is critical for the sustainable treatment and management of the patient’s anemia. A crucial factor in the patient’s follow-up procedure is treating the underlying kidney issue that resulted in the anemia; this can involve reference to a nephrologist for comprehensive check-up and treatment of the kidney issue to prevent the recurrence of the health issue (Babitt et al., 2021). Other follow-up recommendations include carrying out a CBC on the patient after three months and periodic checks of the patient’s hemoglobin, hematocrit, and ferritin levels.