Severely Low Hemoglobin And Hematocrit Count In Adult

Case Study:
A patient presents in the ER with a severely low hemoglobin and hematocrit count. Symptomatology includes listlessness, pale, pallor, and hypotensive. The initial assumption is blood loss via the gastrointestinal tract. As either an FNP or an AGACNP learner, provide an initial evaluation for either a pediatric or an adult patient. In addition, include the following in your presentation: Severely Low Hemoglobin And Hematocrit Count In Adult

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1. The presentation of the patient
2. A list of possible conditions that present similarly based on the patient’s symptoms

Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Normal Hb levels for females is between 12.1 g/dL and 15.1 g/dL
It follows that a low Hb for a female patient is below 12.1 g/dL
Normal hematocrit levels range between 36% and 44% for females
A low hematocrit level is therefore below 36%.
A low Hb and hematocrit are indications that the patient is suffering from anemia whose cause has to be established.
In a patient with anemia and hypotension, the probable cause may be blood loss which is the cause of hypovolemia resulting in hypotension (Hammer & McPhee, 2018; Huether & McCance, 2017)Severely Low Hemoglobin And Hematocrit Count In Adult.

The patient in this case is a 29 year-old Caucasian female with a history of peptic ulcers.
She is a single mother of four who lost her job the previous month and is currently struggling financially. This presents a stressful situation that is bound to worsen the peptic ulcers due to vagal activity on the parietal cells that secret hydrochloric acid in the stomach (Hammer & McPhee, 2018; Huether & McCance, 2017)Severely Low Hemoglobin And Hematocrit Count In Adult.

The patient presents to the ED with hypotension, palor, restlessness, and dizziness.
She is also lethargic and appears to be drowsy.
Her blood pressure is 95/55 mmHg.
On palpating the abdomen, it is hard like a board and there is intense guarding due to tenderness.

Given her medical history, the initial diagnosis made is a perforated peptic ulcer (Hammer & McPhee, 2018; Huether & McCance, 2017)Severely Low Hemoglobin And Hematocrit Count In Adult.
This causes gastrointestinal bleeding that presents a surgical emergency. The resulting peritonitis causes tenderness and guarding on palpation.
The patient has hypotension because blood is lost into the abdominal cavity causing hypovolemia.
Anemia occurs as the number of red blood cells goes down from the blood loss.

The patient gave a history of having missed her monthly period, which she believes has just been delayed.
For the above reason, the most likely differential diagnosis is a ruptured ectopic pregnancy (Hammer & McPhee, 2018; Huether & McCance, 2017).
The others could be long-standing iron-deficiency anemia complicated by hypovolemia; or neurologic hypotension explaining the low blood pressure but not the anemia (Hammer & McPhee, 2018; Huether & McCance, 2017)Severely Low Hemoglobin And Hematocrit Count In Adult