Mr. Robinson Condition

Mr. Robinson Condition

  1. Introduction

Often observable characteristics of people lead a physician to approximate the condition of person expressing those symptoms. However, such approximations may be imprecise because various diseases share symptoms and signs and laboratory examination helps clarify the actual condition. This paper discusses a case of Mr. Robinson in light of the observable signs he manifests and laboratory examination results.

  1. What do the clinical results reveal about this man’s present condition?
  • Blood Pressure

The blood pressure of the client, Mr. Robinson, indicates 80/60 mmHg, which is below the normal value 120/80 mmHg (Blood Pressure Association 2008). A lower than normal BP may indicate a problem with the cardiovascular function. One condition that could a likely cause of low blood pressure is anemia caused by many factors including, vitamin B2 and folate deficiency, (Fairfield & Fletcher 2002) blood loss, and malfunction of the bone marrow.

  • Pulse

Mr. Robinson’s pulse rate of 130 beats per minute exceeds the normal 60 to 100 beats/minute. This parameter reveals that the patient has sinus tachycardia caused by some bodily stress, which makes the heart beat faster to meet the increased energy demands of the body (Remedy Health Media 2014). These body stresses may be anemia, fever or severe infection, overactive thyroid function, acute blood loss and dehydration, chronic de-conditioning, anxiety, pulmonary embolism and various medications (Remedy Health Media 2014).

  • Respiratory Rate

A respiratory rate of 36 breaths per minute is extremely high respiratory rate because the normal respiration rate is from 12 to 20 breaths/min (John Hopkins Medicine n.d.).  Twenty one percent of patients with a respiratory rate of 25 to 29 breaths per minute die in hospital, with risk of death increasing as the rate increases (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris 2008). This indicates that Mr. Robinson needs urgent medical intervention to avert fatality. Possibly, he might need blood infusion.

  • Pale, Cold and Clammy Skin

This symptoms show that the client has reduced levels of blood. In addition, he suffers a long-term medical condition or an acute serious condition. Therefore, the client could be anemic or having internal hemorrhage (Krucik 2014).

  • Anxiety and Confusion

This symptom shows that the current threat of closure of the factory where the client works predisposes him to anxiety and subsequent substance abuse. This situation may have exposed him to unhealthy eating habits leading to lack of nutrients essential to maintain good health. People with anemia tend to manifest anxiety disorders (M. Chen, Su, Y. Chen, Hsu, Huang, Chang, T. Chen  & Bai 2013), which further reinforces the suggestion that the client may be anemic.

  1. How do the laboratory test results reveal about Mr. Robinson’s condition?

From the test of the blood sample A, the patient has normal serum levels of sodium, potassium, creatinine and urea. This helps rule out any renal abnormality (Laing 2011). However, blood sample B showed a hemocratic level lower than normal, which signifies anemic condition. Thus, the patient has anemia most likely due to blood loss (McClathchey 2002; Corner 2005).  Moreover, his hemoglobin level is below the normal 13g/dL for adult males (M. Ensminger & A. Ensminger 1994), which indicates that he is anemic.

  1. What do you conclude his diagnosis to be based on you understanding of all the results above?

The most likely diagnosis is that Mr. Robinson is anemic

  1. What other tests could house physicians carry out to strengthen the diagnosis?

Other test that a house physician could perform microscopic examination of the characteristics of red blood cells to establish the type anemia (Porth 2011). Normal morphology of the RBC rules out, iron deficiency anemia, magaloblastic anemia, pernicious anemia. While measuring serum ferritin helps distinguish anemia due to blood loss from that of bone marrow deficiency [aplastic anemia] (Goroll & Mulley 2009).

Additional test to confirm whether the anemia may be because of internal bleeding may involve examination of the stool to check for blood clots. If the test turns positive, additional tests may be necessary to identify the source of blood. Endoscopy helps indicate the lesions in the body that bleed (NHLBI n.d.).

 

References

American Heart Association 2014, Understanding Blood Pressure Readings, viewed 3 March 2014, http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp

Blood Pressure Association 2008, What is normal blood pressure?, viewed 4 March 2014, http://www.bloodpressureuk.org/BloodPressureandyou/Thebasics/Whatisnormal

Chen, M, Su, T, Chen, Y, Hsu, J, Huang, K, Chang, W, Chen, T & Bai, Y 2013, ‘Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationawide population-based study’, BMC Psycgiatry, vol. 13, pp. 1-8.

Comer, S 2005, Delmar’s critical care: Nursing care plans, Thomas Delmar Learning, Clifton Park, NY.

Cretikos, M, Bellomo, R, Hillman, K, Chen, J, Finfer, S & Flabouris, A 2008, ‘Respiratory Rate: The Neglected Vital Sign’, The Medical Journal of Australia, vol., 188, no. 11, pp 657-659.

Ensminger, M & Ensminger, A 1994, Food and Nutrition: Encyclopedia, CRC Press, Boca Ratoa, Florida.

Fairfield, K & Fletcher, R 2002, ‘Vitamins for chronic disease prevention in adults’, The Journal of American Medical Association, vol. 287, no. 23, pp. 3116-3127.

Goroll, A & Mulley, A 2009, Primary care medicine: office evaluation and management of adult patient, Lippincott Williams & Wilkins, Philadelphia.

John Hopkins Medicine n.d., Vital Signs: Body Temperature, Pulse Rate, Respiration Rate, and Blood Pressure, viewed 3 March 2014, hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/vital_signs_body_temperature_pulse_rate_respiration_rate_blood_pressure_85,P00866/

Knott, L 2012, December 13, Full Blood Count, viewed 3 March 2014, http://www.patient.co.uk/doctor/full-blood-count

Laing, C 2011, ‘Laboratory Investigation: Clinical Approach to Elctrolyte Abnormalities’, Medicine, vol. 39, no. 6, pp. 325-332.

McClathchey, K 2002, Clinical Laboratory Medicine, Lippincott Williams & Wilkins, Philadelphia.

National Heart Lung and Blood Institute (NHLBI) n.d., Disease and conditions index, viewed 4 March 2014, http://www.nhlbi.nih.gov/health//dci/Diseases/anemia/anemia_diagnosis.html

Porth, C 2011, Essentials of pathophysiology: concepts of altered health states, Lippincott Williams & Wilkins, Philadelphia.

Remedy Health Media 2014, What Causes a High Resting Pulse and What Should be Done, viewed March 3, 2014, from Health Central : http://www.healthcentral.com/heart-disease/ask-doctor-44715-70.html

Robinson, A 2012, November 20, Syncope/Collapse, viewed March 3, 2014, from Patient : http://www.patient.co.uk/health/syncopecollapse

Thomas, D 2007, The White Cell, viewed March 3, 2014, from CBE: w.imvs.sa.gov.au/wps/wcm/connect/e81b5545-3b0d-4b3d-819e-10175b0e39cc/cbe-part-3-white-cell-count.pdf?MOD=AJPERES

 

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