NR 603 Week 1 Discussion_Iron Deficiency Anemia - Elena Marino a 34-year-old female

diagnostics, prescriptions, all come straight from the client’s pockets. Plus, the client is currently unemployed. Not only does the client get zero help from insurance, but since they are unemployed, they are most likely very strict on funds in general. However, you never know one’s specific situation until you sit down and talk to them. The situation could be completely different once you talk with the client. It is important to determine the situation before proceeding with treatment plan. This is due to the situation guiding the plan based on available resources and funds. The client could be struggling to make ends meet with being unemployed which resulted in her choosing not to have health insurance due to limited funds. Alternatively, the client could have inherited a significant amount of money, leading to no need for a stable income via work and personally chose to not have healthcare, despite the costs and savings. 4. Locate the most current clinical practice guidelines (CPG) for the client’s primary and secondary diagnoses. Considering your assigned client’s situation and the current CPGs, what is your recommended management plan? Explain your rationale and support it with evidence. Due to the client’s specific situation, it may be beneficial to attempt to treat the patient with over-the-counter proton pump inhibitors and oral iron supplements first. It is also dependent on the client’s current blood work. This current management plan would be for if the client’s hemoglobin was NOT life threatening. Pharmacology wise, I would prescribe the patient pantoprazole 40mg (1 tablet) PO once daily for 8 weeks (dispense 1 bottle that contains 30 tablets with 1 refill). I understand that this is not over the counter, but if the client uses GoodRx, the price can be as low as six dollars, which is cheaper than the typical OTC options. I would also prescribe polysaccharide iron complex 150mg (1 tablet) PO once daily for 3-6 months (dispense 1 bottle that contains 90 tablets with 1 refill). Again, if the client uses GoodRx, the iron can be as low as 13 dollars. The reason for prescribing polysaccharide iron complex is due to its decreased association with gastrointestinal side effects (Lolascon et al., 2024). Have the client follow up in 1 month for a recollection of CBC to evaluate hemoglobin level. I would like to also check serum ferritin and transferrin saturation levels to evaluate if iron supplements are working. However, client may not agree due to costs of repeated labs. It is important to educate the client on when to seek emergency care. If there is no improvement in clinical status, or if progressively worse with signs of bleeding, seek immediate care. The client would more than likely benefit from IV iron and PPI administration, possibly blood transfusion (dependent on hemoglobin level), but this may not be possible for the client due to lack of insurance and employment. If the client does not improve with oral treatment, the next step will be intravenous. References