Question

A patient with a glomerular filtration rate (GFR) of 30 mL/min has a hemoglobin of 5 g/dL. The peripheral smear tests show that the red blood cells are normocytic and normochromic. The nurse suspects that which physiologic change led to this condition?

A. Reduced excretion of potassium
B. Increased extracellular fluid volume
C. Defective reabsorption of bicarbonate
D. Decreased production of erythropoietin

Answer 1

A patient with a low glomerular filtration rate and low hemoglobin, but with normally appearing red blood cells, is likely experiencing anemia due to decreased production of erythropoietin, a common consequence of kidney dysfunction.

Step-by-step explanation:

A patient with a glomerular filtration rate (GFR) of 30 mL/min and a hemoglobin of 5 g/dL, exhibiting normocytic and normochromic red blood cells (RBCs) on a peripheral smear, is most likely to have anemia due to decreased production of erythropoietin (EPO). Kidney damage or chronic kidney disease, indicated by the reduced GFR, impairs the kidneys' ability to produce EPO. As EPO stimulates the production of RBCs in the bone marrow, a deficit can lead to anemia, even when the RBCs produced are of normal size and hemoglobin concentration, as observed in this case. Options A, B, and C are not directly related to the production of RBCs, and so would not typically result in normocytic, normochromic anemia.