DIVINE WORD COLLEGE OF BANGUED

Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003

DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

I. INTRODUCTION
a. Background of the Study

Anemia is a condition in which the number of red blood cells or the hemoglobin
concentration within them is lower than normal. Hemoglobin is needed to carry oxygen and if a
person has too few or abnormal red blood cells, or not enough hemoglobin, there will be a
decreased capacity of the blood to carry oxygen to the body’s tissues. (WHO, 2021)

Anemia is a global public health problem affecting both developing and developed
countries at all ages. The optimal hemoglobin concentration required to meet physiologic needs
varies by age, sex, elevation of residence, smoking habits and pregnancy status however,
according to the World Health Organization (WHO), anemia is defined as hemoglobin (Hb)
levels <12.0 g/dL in women and <13.0 g/dL in men.

Various factors can contribute to having anemia which in turn categorize anemia to
different types:

 Aplastic anemia - a condition that occurs when the body stops producing enough new
blood cells. A rare and serious condition, aplastic anemia can develop at any age. It
can occur suddenly, or it can come on slowly and worsen over time. It can be mild or
severe.
 Iron-deficiency anemia - a common type of anemia — a condition in which blood
lacks adequate healthy red blood cells. As the name implies, iron deficiency anemia is
due to insufficient iron.
 Sickle cell anemia - one of a group of inherited disorders known as sickle cell disease.
It affects the shape of red blood cells, which carry oxygen to all parts of the body. In
sickle cell anemia, some red blood cells are shaped like sickles or crescent moons.
These sickle cells also become rigid and sticky, which can slow or block blood flow.
 Thalassemia - an inherited blood disorder that causes the body to have less
hemoglobin than normal.
 Vitamin deficiency anemia - is a lack of healthy red blood cells caused by lower than
usual amounts of vitamin B-12 and folate. This can happen if a person doesn't eat
 DIVINE WORD COLLEGE OF BANGUED
Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003
DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

enough foods containing vitamin B-12 and folate, or if the body has trouble absorbing
or processing these vitamins. Without these nutrients, the body produces red blood
cells that are too large and don't work properly. This reduces their ability to carry
oxygen.

Iron deficiency anemia is the most common form of anemia, and blood loss is often the
cause. As presented later on by the case of this particular patient. Blood loss can lead to low
levels of iron in the blood, causing anemia. When the body loses blood, it draws water from
tissues beyond the bloodstream to help keep the blood vessels full.

There are many things that can lead to a lack of iron in the body. In men and post-
menopausal women, the most common cause is bleeding in the stomach and intestines.

This can be caused by a stomach ulcer, stomach cancer, bowel cancer, or by taking non-
steroidal anti-inflammatory drugs (NSAIDs).

The common symptoms of iron deficiency anemia include:

 tiredness and lack of energy (lethargy)

 shortness of breath
 noticeable heartbeats (heart palpitations)
 a pale complexion

If iron deficiency anemia is left untreated, it can make a person more susceptible to
illness and infection, as a lack of iron affects the body's natural defense system (the immune
system).

Severe iron deficiency anemia may increase the risk of developing complications that
affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure,
where the heart is unable to pump enough blood around the body at the right pressure.

Chronic gastrointestinal bleeding is the most common cause of iron deficiency anemia in
the general population. Gastrointestinal (GI) bleeding is a common clinical problem frequently
 DIVINE WORD COLLEGE OF BANGUED
Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003
DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

requiring hospitalization. It can vary in degrees, from massive life-threatening hemorrhage to a

slow, insidious chronic blood loss.

Mild, chronic GI blood loss may not show any active bleeding, but can still result in an
iron deficiency anemia. Many of these patients never notice any blood loss, but it occurs in small
amounts with the bowel movement so that it is not noticeable. Blood in the stool often can be
detected by hemoccult testing (testing for blood in the stool) during a routine office examination.

In more severe cases of chronic or acute bleeding, symptoms may include signs of
anemia, such as weakness, pallor, dizziness, shortness of breath or angina. More obvious
bleeding may present with hematemesis (bloody vomit), which may either be red or dark and
coffee-like in appearance.

Blood in the stool could either be bright red, burgundy and clotted, or black and tarry in
appearance, depending on the location of the bleeding source. A black, tarry stool (melena) often
indicates an upper GI source of bleeding although it could originate from the small intestine or
right colon. Other causes of a black stool might include iron or ingestion of bismuth (Pepto-
Bismol). Hematochezia, or bright red blood can be mixed in with the stool or after the bowel
movement and usually signifies a bleeding source close to the rectal opening. This is frequently
due to hemorrhoids; however, one should never assume rectal bleeding is due to hemorrhoids.
Conditions like rectal cancer, polyps, ulcerations, proctitis or infections can also cause this type
of bright red blood.

Anemia is the most common blood disorder, and according to the National Heart, Lung,
and Blood Institute. Anemia of any cause affects around 30% of the global population. Iron
deficiency affects around 1 billion people worldwide, and is the most common cause of anemia.
It is especially prevalent in lower-income regions, such as sub-Saharan Africa, South Asia, and
the Caribbean.

Globally, it is considered a public health issue and is often caused by iron deficiency.
Iron-deficiency anemia (IDA) often originates from blood loss from lesions in the
 DIVINE WORD COLLEGE OF BANGUED
Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003
DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

gastrointestinal tract in men and postmenopausal women, and its prevalence among patients with
gastrointestinal bleeding has been estimated to be 61%.

In the Philippines, Iron Deficiency Anemia, often known as IDA, is a common condition.
Pregnant women make up (26.4%) of the anemic population in the Philippines, followed by
elderly men (23.0%), and nursing mothers (16.7%).

b. Rationale for Choosing the Case

c. Significance of the Study

This study will prove significant to the following:

To those affected by the disease: this study will help them understand their disease as well as
their course of treatment

To the society: this study will benefit the society for the simple reason that it discusses a
common disease among the general population. This study will help the public identify risk
factors, signs and symptoms and plausible treatments

To the students: this study will contribute to their education especially on the study of this
particular disease and the care plans and management that are appropriate for the case

To the academe: this will benefit the academe, more specifically nurse educators…..

To the researchers:

II. PATIENT’S PROFILE/BIOGRAPHICAL DATA

Name: Patient X

Age: 31 years old

Sex: Male

Address: Zone 2, Bangued, Abra

 DIVINE WORD COLLEGE OF BANGUED
Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003
DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

Birthdate: May 5, 1992

Birthplace: Bangued, Abra

Educational Attainment: College Level

Occupation:

Nationality: Filipino

Religion: Iglesia ni Cristo

Name of Hospital: Abra Provincial Hospital

Date of Admission: September 5, 2023

Time of Admission: 12:32 pm

Ward: Medical Ward

Case #: 019037

Admitting Diagnosis: Anemia secondary to LGIB

Final Diagnosis: Anemia secondary to UGIB

Admitting Physician: Dr. Y

Attending Physician: Dr. Z

Chief Complaint: Blood in stool

Date of Discharge: 2023

III. NURSING HEALTH HISTORY

a. Present History of Illness
b. Past Medical History
c. Family History of Illness
d. Socio-Economic History/Psychosocial Profile
 DIVINE WORD COLLEGE OF BANGUED
Rizal Street, Zone 6, Bangued, Abra Telefax: (074)7528003
DEPARTMENT OF NURSING
“Nurturing Students to become Christian-Values Oriented, Socially Responsive and Globally Competitive”
___________________________________________________________________________________

IV. GENERAL SURVEY