Cultural/Faith Leader Interview

Cultural/Faith Leader Interview

Individual Project (Cultural/Faith leader interview and PowerPoint)

You will be creating a PowerPoint presentation that will cover healthcare/nursing, spirituality, & ethics. This presentation will be based on a personal interview you will have with a spiritual leader that is a different faith than your own. You will need to post your choice within the discussion board titled “Cultural/Faith Leader Project”. In order to avoid duplicate presentations and provide a variety of cultures/faiths, you will all need to select a different choice. The interview must be done with a faith leader and not just a member of that faith. Plan for this assignment in advance since scheduling a personal interview will take time. Nearly every student has commented on how much they enjoyed and learned from this assignment.

Additional assignments: There are 2 shorter writing assignments one of which require interviewing/polling coworkers and one that requires some reflection about some of your own personal beliefs about ethical issues. Plan on looking at these assignments (especially the Professional Liability assignment) a few weeks in advance since research regarding your institutions legal coverage is required and a few students found that contacting the appropriate person in their workplace has been challenging.

Figure 1A. Nikoleta’s red blood cells Figure 1B. Normal red blood cells

The hematologist meets with the Stamos family in the exam room. “Mr. and Mrs. Stamos, there are some things that do not look normal in Nikoleta’s blood. I am not sure of the cause, but I do know that Nikoleta’s red blood cells aren’t shaped correctly and they are not the right color. The red blood cells should be very red under the microscope and her red blood cells are light pink.”

Mrs. Stamos asks, “Does it matter if her red blood cells aren’t red?”

The hematologist replies, “Yes, it does matter. Healthy red blood cells are very red and carry oxygen. Nikoleta’s red blood cells aren’t able to carry much oxygen to her tissues. I have an additional concern as well. Sometimes disorders like anemia can have a genetic basis. I would like to have both of you to give a sample of blood for a complete blood count.”

The findings from both parents are mild hypochromia and macrocytic (lightly colored and large cells) anemia. The hematologist gives a diagnosis of erythroblastic anemia for both Mr. and Mrs. Stamos.

Questions

5. Are the lab results of the CBC normal? Which values are normal and which are not?

6. Why are there different normal values for hemoglobin levels and RBC count in males and females?

7. Do red blood cells normally have nuclei?

8. Why was an analysis of Mr. and Mrs. Stamos’ blood ordered?

9. Would a picture of Mr. Stamos’ red blood cells look like Nikoleta’s red blood cells?

10. What is erythroblastic anemia?

Dr. Stephens receives a full report from the hematologist and digital images of Nikoleta’s skull.

Figure 2A. Nikoleta’s skull radiograph.

.jpg”>Figure 2B. Normal skull radiograph.

Question

11. Does the radiograph of Nikelta’s skull appear normal? How are the two radiographs different?

Part III – The Family Returns

Dr. Stephens calls Mr. and Mrs. Stamos and asks that they come in for a follow-up visit. This time the parents meet with Dr. Stephens in his office, not in the exam room. After they are seated, Dr. Stephens informs them that Nikoleta’s condition is very serious.

“I am sorry to give you bad news. Nikoleta does have anemia but, unfortunately, giving her a high iron formula was exactly the opposite of what should be done. Nikoleta’s disorder has a genetic basis.”

“But neither one of us has any of the problems Nikoleta has. We aren’t tired all the time. We work out every day,” replies Mr. Stamos.

“That’s a very good thing, and it has probably helped to keep you and your wife healthy. You both have a much milder form of anemia. Unfortunately, Nikoleta’s condition is more severe.”

Questions

12. What is the most likely diagnosis for Nikoleta?

13. What are the general features of this disease?

Part IV – The Doctor Continues

Dr. Stephens continues, “Nikoleta has what is known as beta-thalassemia, which is also called Cooley’s anemia. Do you remember when I spoke with you about hemoglobin and how it functions to carry oxygen? Well, there are two types of hemoglobin proteins involved in the process of carrying oxygen, alpha and beta. You need both of them in order to have properly working hemoglobin. Nikoleta’s beta proteins don’t function correctly. I have spoken to Dr. Jeff Williams, a hematologist who specializes in childhood disorders of the blood. Nikoleta’s condition is very grave and it has a high mortality rate. Her life span may be significantly shortened. Dr. Williams is the best specialist in this area and I believe he will give her the best care possible. He will keep me informed of Nikoleta’s progress. Meanwhile, Nikoleta will still need to see me for her regular checkups. Also, I don’t know what you are considering for the future of your family, but because of these findings, I suggest that you see a genetic counselor before deciding to have another baby. A genetic counselor will give you all the information about how beta-thalassemia is transmitted from parent to child so that you can make an informed decision about having more children naturally.”

Questions

14. What is the structure of hemoglobin and how is oxygen bound to it?

15. What are some possible treatments that Dr. Williams will suggest?

16. If you were the genetic counselor, what would you suggest to Mr. and Mrs. Stamos concerning having more children? Why?

References

Infant formulas.

http://www.medicinenet.com/infant_formulas.

Cooley’s Anemia Facts and Background.

http://www.cooleysanemia.org

Children’s Hospital Oakland, Northern California Comprehensive Thalassemia Center website.

http://www.thalassemia.com.

Cooley’s Anemia Foundation, Inc. website.

http://www.thalassemia.org/gohome.html.

Joint Center for Sickle Cell and Thalassemic Disorders website.

http://cancer.mgh.harvard.edu/medOnc/sickle.htm

Website describing main features and treatments of thalassemia.

http://www.wrongdiagnosis.com/b/beta_thalassemia

3D models of hemoglobin showing binding of heme and iron. http://www.umass.edu/molvis/tutorials/hemoglobin/heme.htm

Marengo-Rowe, A J.2006. Structure-function relations of human hemoglobins. Proc (Bayl Univ Med Cent) 19(3): 239–245.

Image Credits

Fig. 1A—Image reprinted with permission from Medscape.com, 2011. Available at: http://emedicine.medscape.com/ article/958850-overview.

Fig. 1B—Digitally altered version of a public domain image from CDC, ID#12104, http://phil.cdc.gov/phil/details.asp.

Fig. 2A—Radiograph from the “Film Teaching Collection” assembled by David J. Sartoris, used with permission of collection custodian, Tudor Hughes, http://bonepit.com/Cases/David%20Sartoris/David%20Sartoris%20Thalassemia.htm.

Fig. 2B—Image courtesy of Dr. Frank Gaillard, Radiopaedia.org (http://radiopaedia.org/), (original file at http:// radiopaedia.org/cases/normal-skull-x-ray), Creative Commons BY-SA-NC (http://radiopaedia.org/licence).

Case copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Originally published February 21, 2012. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.