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Goats

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Submitted By october2010
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The most likely diagnosis for the 24 year old vegetarian who exercise 6 days per week, has a glass of one every evening with dinner, and is experiencing cold intolerance and fatigue, is iron-deficiency anemia. Iron deficiencies have been found to occur frequently in athletes and young adults who exercise excessively. Iron deficiency is common in those who exercise frequently because of the amount of iron that is expelled from the body through excessive sweating (Wouthuyzen-Bakker & Assen, 2015). Iron-deficiency anemia is common in vegetarians because of the lack of animal proteins consumed. Meats, including fish, red meats, and poultry, help the body absorb iron. Without consuming meat or supplementing iron through other foods or vitamins iron levels are often low in vegetarians (Beck, Conlon, & Kruger 2014). Fatigue and cold intolerance are common symptoms of iron-deficiency anemia (Lewis, Dirksen & Heitkemper, 2014).
A full history and physical exam should be done for this patient in order to detect any other underlying causes. The patient should be assessed for other signs and symptoms of iron-deficiency anemia such as heart palpatations, shortness of breath, headaches, paleness, or pruritus. A complete blood count should also be done on this patient to determine the levels of serum ferritin (Callachand, 2015).
One pharmacologic treatment option for iron-deficiency anemia is an oral iron supplement. By taking supplemental iron the patient will get the amount of iron needed to maintain normal blood levels that she is not getting from her diet. There are also alternatives which are called sodium ferrous gluconate and iron sucrose, these are used when anaphylaxis may be possible (Lewis, Dirksen & Heitkemper, 2014). Non-pharmacologic treatment options include educating the patient on iron rich foods that comply with her vegetarian diet. The patient should also be educated on the connection between excessive exercise and alcohol consumption and iron-deficency anemia so she can make appropriate lifestyle changes in order to treat anemia effectively (Callachand, 2015).
Long term complications often do not occur with iron-deficency anemia unless it is not treated appropriately. Some long term affects may include increased risk for infection, pregnancy complications, and heart or lung problems (Callachand, 2015).
Beck, K., Conlon, C., Kruger, R., & Coad, J. (2014). Dietary Determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review [Abstract]. Nutrients, 6(9), 3747-3776. Retrieved March 2, 2016, from http://www.mdpi.com/2072-6643/6/9/3747/htm
Callachand, N. (2015). Iron deficiency anaemia. Chemist & Druggist, 16-18. Retrieved March 2, 2016, from http://eds.b.ebscohost.com.lib.kaplan.edu/eds/pdfviewer/pdfviewer?vid=6&sid=c8d986e4-7941-4528-8b1d-7ef9012a5ed4@sessionmgr111&hid=122
Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L., & Harding, M. (2014). Medical surgical nursing assessment and management of clinical problems (9th ed.). St. Louis, MO: Elsevier Mosby.
Wouthuyzen-Bakker, M., & Assen, S. V. (2015). Exercise-induced anaemia: A forgotten cause of iron deficiency anaemia in young adults [Abstract]. British Journal of General Practice, 65(634), 268-269. Retrieved March 2, 2016, from http://eds.a.ebscohost.com.lib.kaplan.edu/eds/pdfviewer/pdfviewer?sid=045d5074-b562-42e9-a974-c0cf99d3737b@sessionmgr4002&vid=7&hid=4208

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