Question

A patient has had chronic bleeding for the past 6 months. Which of the following lab results would the nurse practitioner expect?

a. Normal reticulocyte count
b. Increased serum iron stores
c. Increased serum ferritin stores
d. Increased MCV

Answer 1

A nurse practitioner would expect a decreased MCV and decreased serum ferritin in a patient with chronic bleeding, indicating microcytic anemia and depleted iron stores.

Step-by-step explanation:

If a patient has had chronic bleeding for the past 6 months, a nurse practitioner would expect to see a decreased MCV (mean corpuscular volume) in their lab results. Chronic blood loss leads to iron-deficiency anemia, which often presents as microcytic anemia, meaning the red blood cells are smaller than normal, reflected by a decreased MCV.

Moreover, long-term bleeding typically causes iron stores in the body to drop, hence decreased serum ferritin stores would also be expected, as ferritin reflects the body's iron stores. Increased serum iron and ferritin are not typically found in cases of chronic bleeding since these stores would have been depleted over time. As for the reticulocyte count, in the case of iron deficiency anemia caused by chronic bleeding, it could be normal or slightly increased as the body attempts to compensate for the anemia, but it would not be as elevated as one would expect in other forms of anemia where RBC production is adequate.