Anemia is caused by a decrease of red blood cells circulating in the human body. This decrease of the red blood cells can result from the body either a non-production of healthy red blood cells, excessive blood loss or a destruction of red blood cells by the body. Symptoms that present with Ms. A are due to Iron deficiency anemia which is a medical condition (Clark & Susan, 2008). The purpose of this paper is to briefly detail the cause of iron deficiency anemia, its signs and symptoms and available treatment for the condition. Iron deficiency anemia This condition is caused by iron deficiency in the blood. Iron is necessary in the production of blood in the body. It is mainly found in the red blood cells and aids in the transporting of both oxygenated and deoxygenated to the body and lungs respectively. A decrease of iron in the body reduces the normal production of hemoglobin which is a protein in the red blood cell thus reducing the amount of oxygen transportation throughout the body (Clark & Susan, 2008) Causes of Iron deficiency anemia Menstruation is a period when women experience blood loss monthly. During menses there could be a heavy blood flow and a lot of blood and iron may be lost during this period. Ms. A reports that she has experience heavy menstrual bleeding for an estimated period 10-12 years. Once there is an excess loss of blood, a certain amount of iron will be lost too. Ms. A is at a greater risk of suffering from iron deficiency due to the prolonged period of time she has experienced the loss of excessive blood through her menses. Use of NSAIDs can contribute to excessive bleeding because it is used to help relieve pain in this case. Prolonged usage of NSAIDs can lead to gastrointestinal bleeding. This can occur if a bleeding ulcer occurs. Inadequate iron intake in the diet can also lead to Iron deficiency anemia (Clark & Susan, 2008). Signs and symptoms of Iron deficiency anemia Ms. A reports shortness of breath, light headedness and fatigue and weakness. These are some of the symptoms of this medical condition. She reports having dysmenorrheal and menorrhagia for a long period of time. This prolonged period of blood loss has contributed to iron deficiency thus reduction of red blood cells to carry oxygen throughout the body. Her low hemoglobin causes her heart to pump extra hard so as to meet the demands of the body for oxygenated blood. Ms. A also suffers from stiff joints which may be caused by a slow cellular regeneration due to the depletion of iron in her body. Iron depletion in the system will also contribute to a slow muscle recovery especially on people who have an active lifestyle that constantly need faster cellular regeneration and muscle recovery to replace lost cells (Killip 2007). Treatment of Iron Deficiency Anemia Treatment for Iron deficiency anemia can be successful with prescription of an iron supplement and pill to be taken by the patient. Ms. A should also include foods rich in iron in her diet to ensure that she is getting adequate iron in her body. The physician should also consider further tests like occult blood tests to ensure that the patient doesn’t have any active internal bleeds. Birth control can also be prescribed to help with menorrhagia and dysmenorrhea (Leung & Wah Chan, 2000). Conclusion Deficiency in red blood cells leads to the body systems not to function properly. Immediate medical attention should be sought so as to avoid further complications that can lead to death.   When the heart loses its capacity to pump oxygenated blood throughout the body to all body parts is a result of Congestive Heart Failure. This usually impairs the performance of the body parts and therefore they don’t function adequately. Congestive heart failure usually causes the heart muscle to be over worked by trying to compensate and pump blood to the body. This eventually leads to the heart muscles becoming enlarged than usual a condition known as cardiomyopathy. Cardiomyopathy causes the heart muscles to enlarge and become weak and stiff. Some of the signs and symptoms of CHF are lung congestions, fluid retention thus causing edema, shortness of breath, weight gain, fatigue, irregular heart rhythm and tachycardia (Baliga & Eagle, 2008). Mr. P presents with signs and symptoms that are consistent with CHF and cardiomyopathy. He presents with labored breathing, crackle sounds in lungs and 4+ pitting edema. The purpose of this paper is to describe the writer’s approach to patient care, recommended treatment and teaching plan for the patient and caregivers. Approach to Care Evidence-based practice will be adapted to enable treatment and care of the patient. This includes an effective management of symptoms so as to prevent the condition from progressing and thus deterioration of patient health. Involving the multidisciplinary team is another approach of care that will help in the management of CHF. The multi-disciplinary team involves, physicians, respiratory therapists, pharmacist, and cardiologists just to name a few of the healthcare team that will be involved in the care of the patient. Mr. P reports feeling hopeless due to his disease process and also his caregiver who is the wife is concerned about their financial constraints and situation. This should be addressed in as part of Mr. P’s care so as to facilitate treatment compliancy. They should be introduced to resources that they can use to help lift some of their financial burden. Therapy for stress reduction and also promoting inner strength for the patient should be encouraged. By educating the patient and family on self-care and need for compliancy should be incorporated so as to achieve better outcomes for the patient (Zambroski, Moser, Bhat & Ziegler, 2005) Treatment plan The treatment plan should aim at reducing the number of readmission of the patient due to the CHF exacerbation. Administering medications as prescribed by the healthcare provider should be adhered to by nursing staff and also teaching should be done on the need to take medication as prescribed. Beta blockers and Lasix are some of the medication incorporated in the treatment to ease symptoms CHF and also assessing how the patient responds to the medication. Oxygen should also be administered for the shortness of breath since Mr. P has crackle sounds throughout the lungs from fluid backing up to the lungs. This ensures that there is enough oxygen circulation throughout the body..The treatment plan should focus on reducing the risk of readmitting CHF exacerbation patients. Mr. P present with signs and symptoms of CHF. Nursing treatment plan include administering medications such as Lasix, beta blockers and assessing the patient’s response to them. Nursing interventions like daily weight monitoring, vital signs and sodium and fluid restriction should be completed. This helps in assessing whether the patient’s condition is being managed as it should or not (Zambroski, Moser, Bhat & Ziegler, 2005). A psycho-social support should be provided and made available to the family. This may include referrals for social care and also spiritual care. Social workers should be involved to aid in the discharge plans so that they can identify any barriers that the patient may face that may interfere with their treatment compliance. They set patients up with resources that may be available for them in the community like rehabilitation programs and community care programs (Zambroski, Moser, Bhat & Ziegler, 2005). Education and counseling Assessment of patient for readiness and willingness to learn should be completed before teaching can take place. Mr. P shows low learning interests. Assessing the barriers to learning will enable the healthcare team identify the best approach to use when providing education to the patient. Teaching promotes behavioral changes that are essential to attain a healthy lifestyle. By encouraging the patient to check their weight and record it every morning will enable the patient identify any problems with fluid retention that could be underlying? The patient should be encouraged to report any weight increase so that treatment can be given in good time. Teaching on medication administration should also be completed to ensure that the patient is taking the medication as prescribed. Some of the signs and symptoms that Mr. P should be educated in looking out for are excessive swelling of the feet, having trouble breathing while lying down, dizziness and wet cough (Michalsen, Konig, & Thimmes, 1998). Monitoring of the blood pressure should also be encouraged. Dietary restrictions should be adhered and patient should meet with a dietician so as to learn of foods to avoid in the diet. A “No added salt” diet should be encouraged to reduce the consumption of sodium which facilitates fluid retention. Salt supplements should be encouraged. Fluid restrictions should also be encouraged. Exercise as tolerated should be encouraged to prevent weight gain (Michalsen, Konig, & Thimmes, 1998). Conclusion Medically managing the condition, education on support and self-care and pharmacological management are some of the interventions that can aid in managing CHF. Involving the care givers in the treatment process is essential so as to encourage the patient with compliancy and also provide support for the patient while they are managing their condition (Krumholz, 1997).