Final Answer:
Ms. Ashley's low red blood cell count is attributed to her chronic kidney disease and subsequent renal anemia, a common complication of kidney dysfunction. The kidneys play a crucial role in producing erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. With impaired renal function, there is a reduced production of erythropoietin, leading to anemia.
Step-by-step explanation:
Ms. Ashley's anemia stems from her chronic kidney disease (CKD), a condition where the kidneys progressively lose their function. The kidneys are essential for producing erythropoietin, a hormone that signals the bone marrow to generate red blood cells (RBCs). In CKD, the impaired renal function results in decreased erythropoietin production, leading to a reduced ability to produce an adequate number of RBCs. This condition is termed renal anemia.
The laboratory results further support the diagnosis, with Ms. Ashley presenting a low hemoglobin level (9.5 g/dl), below the normal range for females. This deficiency in hemoglobin indicates a diminished capacity of her blood to carry oxygen, contributing to her fatigue and shortness of breath. The lowered hematocrit (32%) and RBC count (3.7 million/mm³) corroborate the diagnosis of anemia.
To address her anemia, evidence-based practice recommends erythropoiesis-stimulating agents (ESAs) such as epoetin alfa or darbepoetin alfa. These medications function as synthetic forms of erythropoietin, stimulating RBC production. Additionally, iron supplementation may be considered to optimize the effectiveness of ESAs.
However, the administration of these treatments requires careful monitoring, considering potential risks, and adjusting doses to avoid complications like hypertension. Collaborative efforts between the nephrologist and hematologist are crucial for a comprehensive and tailored management plan.
Here is Complete Question:
" A 53-year-old woman, Ms. Ashley, has been admitted to the medical floor for treatment of severe anemia. She has a history of renal disease and has been undergoing dialysis three times a week for a year. She has had no severe problems since beginning dialysis but has recently begun to feel quite weak and fatigued. She owns a business and has needed help with the daily aspects of the business for the past month. While the nurse is completing the admission forms, she says that she has so much to do and does not really "have time to be sick." However, she admits that she cannot keep up her usual pace because she is "so tired all the time." A focused assessment reveals pallor of the skin and mucous membranes, she also complains of becoming short of breath after any activity, such as walking from her office to the car. The arteriovenous fistula on her left forearm is intact, with a palpable thrill and audible bruit. Her last dialysis was yesterday; she was able to complete the session, but it left her exhausted and she was unable to drive home.Labs: Result Reference Range WBC 5500 mm3 5,000–10,000/mm3 RBC 3.7 million/mm3 4.2–5.4 million/mm3 (females) Hemoglobin 9.5 g/dl 12–16 g/dl (females) Hematocrit 32% 37%–47% (females) Platelet Count 250,000 mm3 150,000–400,000/mm3 Iron (Fe) 48 mcg/dL 60–160 mcg/dL (females) 1. Ms. Ashley asks why her red blood cells are low. What is the pathology of her lack of red blood cells? 2. What could be a possible treatment(s) for her anemia based on current evidence-based practice? Please help im studying this. need more help understanding "