After reviewing the course textbook (attached), summarize the history of nursing research. Discuss the importance of nursing research as it relates to applying evidence in practice (evidence-based practice).

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format.

Please, use at least y citation from the attached book, as a proof I already reviewed it.

 

Macrocytic Anemia

Selected Condition: Macrocytic Anemia

Macrocytic anemia is characterized by large red blood cells (macrocytic) and poor oxygen-carrying capacity. The term macrocytic is used to describe the size of red blood cells, and this can be ascertained from a blood test that computes the mean corpuscular volume (MCV). If the MCV exceeds 100 fL, the anemia is described as macrocytic. Low levels of vitamin B12 or folate, alcoholism, liver diseases, and some medications can cause this condition. Macrocytic anemia has general signs and symptoms and a detailed investigation is needed before diagnosing the cause.

Rationale for Selecting Macrocytic Anemia

I chose macrocytic anemia because it is a relevant and common problem in clinical practice. Anemia is prevalent among hospitalized patients, whereas macrocytic anemia is a subtype that may be associated with various diseases. Anemia can be a sign of a lack of necessary nutrients like vitamin B12 and folate or an indication of liver problems or medication that affects red blood cell formation (Moore, 2022). Knowledge of macrocytic anemia is crucial since it is at the core of patient care, including diagnosis, management, and patient counseling. Also, macrocytic anemia is another important differential in patients with chronic alcohol use or gastrointestinal pathology, which is significant to my practice as a nurse working in outpatient healthcare.

Prevalence and Incidence of Macrocytic Anemia in the United States

Macrocytic anemia is relatively high in the United States; it affects elderly patients and those with certain risk factors. A cross-sectional study by the National Center for Biotechnology Information (NCBI) reveals that macrocytosis, the major characteristic of macrocytic anemia, affects 2-4% of the population (Moore, 2022). The condition is more likely to be noticed in patients who are of advanced age. Specifically in elder care, the prevalence may increase to 10% due to factors like low nutritional intake, diseases, and medication hindering nutrient absorption (Moore, 2022).

The prevalence of macrocytic anemia also depends on the diseases that may lead to vitamin deficiency, including malabsorption disorders, autoimmune diseases, and chronic alcoholism. According to a survey by the American Society of Hematology, researchers found that vitamin B12 deficiency is the leading cause of macrocytic anemia in the United States, and the most affected group is the elderly (Soliman et al., 2024). Folate deficiency is another common cause, though it is less prevalent than the former. Furthermore, patients with alcohol use disorder require special consideration because alcohol interferes with folate metabolism and red blood cell formation, making patients with alcohol use disorder more prone to macrocytic anemia.

It is also important to note that macrocytic anemia is common in hospitalized patients and those with gastrointestinal or hematologic diseases. In a cross-sectional study that focused on adult inpatients, they identified that nearly 10% of the patients had macrocytic anemia, indicating this condition’s importance in the clinical setting (Rogers, 2023).

Summary of Scholarly Article on Macrocytic Anemias

The article “Macroytic Anemia” gives detailed information about the pathophysiologic mechanisms, etiologies, and clinical signs of macrocytic anemia (Koury & Hausrath, 2024). The article highlights that the underlying causes of macrocytic anemia include:

• Vitamin B12 deficiency: Vitamin B12 is very important for developing red blood cells in the human body. B12 deficiency causes a decrease in DNA replication in the bone marrow, which leads to the creation of oversized red blood cells.
• Folate deficiency: Folate is another vitamin required for DNA synthesis in the body, similar to vitamin B12. Folate deficiency fails to produce normal red blood cells in the bone marrow, which are instead more significant.
• Alcoholism: Alcohol affects folate metabolism and red blood cell formation, and when taken in the long run, it can lead to macrocytic anemia.
• Liver disease: Liver disease may also affect the metabolism of vitamin B12 and other nutrients, resulting in macrocytic anemia.
• Medications: Some drugs, like methotrexate or antiretroviral agents, interfere with the synthesis of red blood cells, leading to macrocytic anemia.

The article also describes the signs of macrocytic anemia; however, some patients may not show any signs or symptoms until the disease progresses to the more advanced stage, which may include fatigue, weakness, and pallor. The management of macrocytic anemia depends on the primary cause. If there is vitamin B12 or folate deficiency, these vitamins should be administered to treat the anemia. For patients with alcohol or liver issues, it is vital to treat the underlying condition in combination with the administration of micronutrients to enhance the patients’ status (Koury & Hausrath, 2024).

The article is directly related to my knowledge of macrocytic anemia as it presents a literature-based review of the causes and management of the condition. The article also pays much attention to early diagnosis; even if it is inconclusive, it is an essential aspect of nursing practice. This way, I will be able to recognize macrocytic anemia and its clinical manifestations and, hence, help manage patients and prevent complications arising from untreated anemia.

Conclusion

Macrocytic anemia is a frequent but severe problem that clinicians should not overlook. Understanding the pathophysiology, symptoms, and factors that can lead to it means that nurses are well-equipped to help diagnose and treat this condition. Macrocytic anemia can be managed with the correct approach to patient education, interprofessional collaboration, and proper medical management. Thus, knowledge of macrocytic anemia risk factors, diagnostic criteria, and possible complications is crucial for nurses to provide their patients with the highest level of care.

References

Koury, M. J., & Hausrath, D. J. (2024). Macrocytic anemias. Current Opinion in Hematology, 31(3), 82–88. https://doi.org/10.1097/moh.0000000000000804Links to an external site.

Moore, C. A. (2022, July 11). Macrocytic anemia. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK459295/#:~:text=Macrocytosis%20affects%202%25%20to%204,and%20vitamin%20B12%20and%20medicationsLinks to an external site..

Rogers, J. L. (2023). McCance & Huether’s pathophysiology: The biologic basis for disease in adults and children (9th ed.). Elsevier.

Soliman, M., Grayland-Leech, B., & Villines, Z. (2024). Macrocytic anemia: Causes, symptoms, treatment, and types. Medical News Today. https://www.medicalnewstoday.com/articles/321620Links to an external site..

 

Good afternoon Dr and classmates,

1. Select a condition covered in this course that interests you or is relevant to your nursing practice. Identify the condition you’ve selected. 
2. Briefly explain your rationale for selecting this particular condition. What influenced your selection? 
3. Investigate the prevalence and incidence of the chosen condition in the United States (U.S.). What are the incidence, prevalence, and affected populations? 
4. Find and summarize a scholarly article that discusses your selected condition. What does the article say about your condition and its pathophysiology and manifestations? How is the article relevant to your understanding of the condition? 

1. Type 1 hypersensitivity, allergic reaction to tree nuts

2.

I have 4 children and my two youngest sons both have allergies to peanuts. The severity of their allergy varies. We as a family are fortunate that their allergy is not as sensitive as other children at their schools. At this point my boys are aware of their allergy and what to avoid. However, we had a bad experience with my children eating holiday candy. We were not aware that candy had nuts in it. It was determined that as long as my children don’t ingest the nuts they are not affected by the exposure. I feel that we are lucky as I have seen children can’t be in the same room as some nuts. I found this interesting to learn how and why their bodies react to this type 1 hypersensitivity. 

3.

Peanut allergy (PA) is a significant public health concern in the United States that affects millions and results in severe health implications. The prevalence of peanut allergies is approximately 2.2% among children and about 1.8% among adults (Bilaver et al., 2024; Chinthrajah et al., 2020). 

A significant portion of those with peanut allergies are children. Statistics suggest that approximately one-quarter of peanut allergy cases arise from individuals who initially appear to be at low risk for developing this condition.

4.

The article titled “Accuracy of component‐resolved diagnostics in peanut allergy: Systematic literature review and meta‐analysis” by Nilsson et al. provides insights into the pathophysiology and clinical manifestations of peanut allergy through its emphasis on diagnostic precision and molecular characterization of allergens. Nilsson et al., (2020) states this systematic review highlights how component-resolved diagnostics (CRD) can identify specific IgE responses to peanut components, which is crucial for understanding the diverse clinical presentations associated with peanut allergy.

Peanut allergy is primarily mediated by immunoglobulin E (IgE) antibodies, which bind to peanut proteins, leading to various allergic reactions upon exposure.

In summary, Nilsson et al.’s article is relevant as it increases understanding of the pathophysiology of peanut allergy, showing the utility of advanced diagnostic tools. This better understanding sets the way for more effective management strategies tailored to individual sensitization profiles and clinical manifestations.

Thank you, 

References:

Bilaver, L., Ariza, A. J., Binns, H. J., Jiang, J., Cohn, R. D., Sansweet, S., … & Gupta, R. S. (2024). 

Design of the intervention to reduce early peanut allergy in children (ireach): a practice‐based clinical 

trial. Pediatric Allergy and Immunology, 35(4). https://doi.org/10.1111/pai.14115Links to an external site.

Nilsson, C., Berthold, M., Mascialino, B., Orme, M., Sjölander, S., & Hamilton, R. G. (2020). 

Accuracy of component‐resolved diagnostics in peanut allergy: systematic literature review and 

meta‐analysis. Pediatric Allergy and Immunology, 31(3), 303-314. https://doi.org/10.1111/pai.13201

Respond to at least two of your peers’ initial posts that offer a different plan of action than yours for either issue. Include the following details in your response:

• Identify at least one different approach to increase the number of participants in your program that was shared by your peers that you did not mention in your post, and explain why considering this solution is useful.
• Identify at least one different plan of action shared by your peers to address the timeline-related issues that you did not mention in your initial post, and explain why considering this solution is useful.