Case Study 3 Anemia



Case Study 3 Anemia

Brandy Schnacker

Washburn University

Advance Pathophysiology

NU 506

Sue T. Unruh, MSN, RN & Karen Fernengel, RN, PhD, ARNP-BC

November 22, 2010

Case Study 3 Anemia

1. From what you know of Henry’s history, what type of anemia do you suspect he has? Explain your answer, and include a brief description of how Henry’s red blood cells appear on a peripheral blood smear.

Henry has the anemia that is classified as chronic disease anemia and also iron deficiency anemia. This anemia is associated with chronic renal failure by the deficiency of erythropoietin (Porth & Matfin, 2009)(page 292). When this hormone becomes depleted the iron also diminishes in your body which is needed to create red blood cells (Causes of Renal Failure & Anemia). The kidneys are the primary site for the production of the hormone erythropoietin, which controls red blood cell production (Porth & Matfin, 2009)(page 864). With his renal failure, Henry’s erythropoietin production is insufficient to stimulate the appropriate red blood cell production by the bone marrow that he needs within his body (Porth & Matfin, 2009)(page 864). The red blood cells will be fewer on a slide when obtained. Also a blood smear slide can show spiculed and deformed red cells (burr cells or echinocytes) (Liberator).

2. Describe the physiological basis that would explain why Henry’s anemia would cause him to have the symptoms he is experiencing.

Henry’s anemia is causing his symptoms by the lack of red blood cells throughout his body. His headache and dizziness is due from the lack of oxygen supply to the brain. The feeling unusually tired and running out of breath is due to the tissue hypoxia. The tissue hypoxia is when the oxygen-carrying capacity of hemoglobin is reduced (Porth & Matfin, 2009)(page 284). Without red blood cells then oxygen cannot be transported equally to all cells throughout the body.

3. Predict the cellular adaptations erythrocytes undergo when chronic hypoxia is present. How would this be evident on an oxygen-hemoglobin dissociation curve?

The cellular adaptations that occur are the increased production of red blood cells that result in the release of erythropoietin from the kidneys in response to hypoxia. Polycythemia increases the red blood cell concentration and the oxygen-carrying capacity of the blood (Porth & Matfin, 2009)(page 702). This can be evident on an oxygen-hemoglobin dissociation curve by the shift to the right which means the increase of oxygen release to the tissues (Porth & Matfin, 2009)(page 702).

REFERENCES

Causes of Renal Failure & Anemia. (n.d.). Retrieved November 22, 2010, from eHow:



Liberator, M. B. (n.d.). Anemia of Chronic Renal Failure. Retrieved November 22, 2010, from

Nephrology:

Porth, C. M., & Matfin, G. (2009). Pathophysiology Concepts of Altered Health States. China:

Lippincot Williams & Wilkins.

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