Final answer:
For a client with chronic kidney disease and anemia, likely interventions include an erythropoietin-stimulating agent to increase red blood cell production, an increase in iron intake, and a dietary consult for low phosphate and high fiber foods.
Step-by-step explanation:
The client's symptoms of extreme fatigue, chest pressure when walking, and trouble breathing when lying supine, along with the significantly low hemoglobin level of 8.3 g/dL (83 g/L), are indicative of anemia likely secondary to chronic kidney disease. In chronic kidney disease, the kidneys' ability to produce erythropoietin (EPO) is compromised, leading to decreased erythrocyte (red blood cell) production.
Considering this, the healthcare provider is likely to prescribe the following interventions:
- Injection of an erythropoietin-stimulating agent: This mimics the action of natural EPO to stimulate the bone marrow to produce more red blood cells, thereby increasing the hemoglobin level and helping alleviate symptoms of anemia.
- Increase in iron intake via food and supplementation: Iron is a critical component needed for hemoglobin production and erythropoiesis.
- Dietary consult to focus on low phosphate foods and high fiber options: This is pertinent in managing chronic kidney disease as it helps reduce phosphate levels, which can be detrimental when the kidneys are not functioning properly.
While not directly mentioned in the scenario, depending on the overall situation, a type and crossmatch for an immediate blood transfusion may also be considered if the anemia is causing significant symptoms and needs rapid correction. However, this is less of a chronic management strategy and more of an acute intervention.
An educational handout on foods to increase the blood platelet count is not indicated in this case, as the patient's primary issue is anemia related to erythrocyte production, not platelet count.