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ANEMIA
• PERNICIOUS
VITAMIN B12 DEFICIENCY
• IRON DEFICENCY
HYPOTENSION
• MAJOR DEPRESSIVE DISORDER
• SEIZURE DISORDER
• Clients Name/Initials: AMD
• Age: 32 years old
• Gender: Female
• Hospital Admitted:
Eduardo L. Joson Memorial Hospital
• Anxiety/nervousness
• Depression
• Gabapentin (Neurontin)
• Precordium
– adynamic precordium upon auscultation, presence of S4 but
unclearly notified
• Abdominal Quadrants
• Internal Organs
• Musculoskeletal structure, skin nails
(lower extremities)
– tingling sensation on both lower extremities
– -pale, untrimmed nails
– -abnormal capillary refilling time due to skin color
• Genitalia
INITIAL MEDICAL DIAGNOSIS
Anemia
Hypotension
LABORATORY STUDIES
NURSING RESPONSIBILITIES TO
EACH LAB EXAM
T/C MAJOR DEPRESSIVE BEHAVIOR
• Self hatred Absent/present
when committed
suicide
• Poor concentration Present
• Fatigue Present
• Digestive problems Present
• Lethargic Present
• Agitated Present
• Forgetfulness Present
• Psychomotor agitation Present
• The patient is depressed and slightly aggressive (she kisses the hands
of the observer agitatedly, cheering) (activity as claimed by the patient’s
mother but defended that her daughter is still in normal functioning,
verbalizing: “ganyan talaga yan, pero hindi naman siya yung sira
talaga”, she has a depressed (sad) mood which appears to the
observer as a personality trait. When taking the patient’s blood
pressure, she always actively straightens her arms.
• She does not, however, have illusions, delusions
or hallucinations.
APPEARANCE:
• Age: 32 years
• Height: 5’6”; Weight: 57 kgs.
• Manner of dressing: normal, neat dress
• Grooming: Slightly combed hair,
untrimmed toe nails
» Observed poor sense of personal grooming
• Attitude:
– Hostile but cooperative
• Behavior:
– Psychomotor agitation, no signs of athetotic movements,
normal eye contact with the observers and family
members
– No mannerisms
• Mood and affect:
– Neutral to euthymic with no presence of Alexithymia
– Depressed
• Speech:
– Clear, spontaneous words of normal intensity, normal
rate
• Thought content and process:
– No flight of ideas, delusions or hallucinations
– Had her suicide attempt 18 years ago, however,
no attempt was observed since then.
• Judgment:
– Can make decisions
• *Since there were no collaborative actions
made by the family to psychiatric health
professionals to diagnose the patient’s
mental disorder, the group based the
diagnosis on the theories and concepts
inscribed in published books and references
on internet and journals. Symptoms were
collected as observed and took the
appropriate one as the diagnosis hence
added to consider on medical diagnosis
made.
– Group 1
PATHOPHYSIOLOGY OF
HYPOPROLIFERATIVE ANEMIA
(Folic Acid Deficiency – IDA,
Hypotension)
PATHOPHYSIOLOGY OF
PERNICIOUS ANEMIA
DEFINITIVE MEDICAL DIAGNOSIS