Question

PN 200 Fundamentals of Nursing II Grading Rubric: Laboratory and Diagnostic Test 15 Points 20 Points Section I Indications Section II Nursing Interventions Section III Potential Complication Section IV Outcome/Evaluation Section V Patient Teaching 20 Points 20 Points 25 Points Section I Why is this test indicated? What disease process can be identified/confirmed by completing this test? Be sure to include normal values. (Please use your de Wit textbook for normal values) Section II What do you have to do to prepare the patient? NPO? Check for anticoagulants? (Use critical thinking skills to apply to what you will be doing) Section III List potential complications for which you would assess the patient Section IV You can choose good or bad outcomes for evaluation Section V List teaching points about the test that are important for the patient to know for their own safety and will contribute to a positive outcome 1/20

Answer 1

INTRODUCTION.

Total iron-binding capacity is one of the types of test performed with blood to measure or to estimate the amount of iron in the blood, it also indicates if more or very less iron is present in the blood.

The human body gets iron by the diet, after entering the iron into the body it is further processed with the help of a protein called transferrin which is produced by the liver, it is performed to evaluate the capacity of transferrin carry out the iron via blood.

Indications.

1. When there is less amount of iron in the blood (anaemia).

2. Menorrhagia- a condition in which excess blood is lost during menstruation.

3. Gestation- the condition in which the need for iron is increased due to growing foetus.

4. Sepsis.

Symptoms that can be seen when there is an amount of iron is less in the blood are:-

* Fatigue and restlessness.

* Yellowish skin colour and pale skin.

* Infection which is chronic in nature.

* Swelling on the tongue can be seen.

* Confusion and irritability.

* Inability to concentrate on a particular task.

* Chill feeling.

This test is also performed when the amount of iron is increased in the blood, it can be due to

1. Poison occur due to lead or iron.

2. Anaemia which is hemolytic in nature.

3. Transfusion of blood on a regular basis or very frequent.

4. When there is a damage in the liver or the liver cells.

Symptoms associated with the increased iron in the blood are.

* Weakness

* Fatigue.

* Pain in joints.

* Pain the abdominal region.

* Reduction in weight.

Normal values.

250 mcg/ dl to 450 mcg/ dl.

2. Nursing intervention

(a) keep the patient nil per oral for at least 7-8 hours before the procedure.

b) check if the patient is on regular medication and if there is some effect of that medication on the result of Total iron-binding capacity, inform the physician regarding the medication before carrying out the procedure or preparing the patient for the procedure.

c) few medications can give false or incorrect results, they are.

* Pills used to control birth.

* Pill contains fluoride.

* Ammonia drugs like corticosteroids.

* Anticoagulants.

d) this procedure is performed by taking a small sample of blood from the patient's vein or artery.

e) clean the site from where the blood is to be withdrawn with an antiseptic solution to make the veins visible and swell.

f) insert the needle once the vein is seen, collect the sample with enough amount of blood needed to perform the procedure.

g) after the withdrawal of blood, take out the needle and put the sample in the sample bottle and send it to the laboratory for the analysis.

h) apply pressure for few seconds after removal of the needle from the veins or artery.

i) follow up with the results of the procedure.

3. Potential complications.

a) uncontrolled bleeding at the puncture site.

b) dizziness or fatigue.

c) formation of a hematoma at the puncture site.

d) sepsis at the puncture site.

4. Outcomes.

a) normal value is 240 mcg/ dl to 450 mcg/ dl.

b) If the value is more than 450 mcg/ dl, it indicates there is less iron in the blood.

c) if the value is less than 250 mcg/ dl, it indicates there is more iron in the blood.

5. Patient education.

1. If there is less amount of iron in the blood, encourage patient to take iron-rich diet.

2. Increase the amount of iron intake during pregnancy, menstruation, and lactation.

3. Take iron and folic acid supplements when anaemia is present.

5. Avoid taking iron supplements or iron-rich diet when there is more amount of iron is present.

6. Consult with the physician when the amount of iron is increased due to the disorders like sickle cell anaemia, hemolytic anaemia, and hemochromatosis.

7. Visit clinician regularly for follow up.

8. Take the medication regularly as prescribed.