Patho Patho #42

Question

The nurse is caring for a client with chronic obstructive pulmonary disorder. Hemoglobin and hematocrit are significantly elevated. The best explanation for this abnormality is:

Answers

  1. anemia of chronic disease.
    • Rationale:

      This answer choice is not correct because anemia is defined as a decreased hemoglobin and/or hematocrit.

  2. anemia related to acute COPD exacerbation.
    • Rationale:

      This answer choice is not correct because anemia is defined as a decreased hemoglobin and/or hematocrit.

  3. polycythemia related to compensation for long-standing hypoxemia.
    • Rationale:

      This answer is correct because increased hemoglobin and hematocrit are common in clients with COPD as a compensatory mechanism for prolonged hypoxemia.

  4. polycythemia related to increased oxygen carrying capacity of the red blood cells.
    • Rationale:

      This answer choice is not correct because with polycythemia, there is not an increase in the actual oxygen carrying capacity of red blood cells. Polycythemia is an increase in the number of red blood cells, rather than their oxygen carrying capacity.

Overview

The focus of this question is asking the nurse to identify the underlying etiology for polycythemia in clients with chronic obstructive pulmonary disorder (COPD). Polycythemia is an increased number of red blood cells. This abnormality occurs in clients with COPD as a compensatory mechanism for prolonged hypoxemia. The body produces more red blood cells in efforts to maintain adequate oxygenation as the red blood cell contains hemoglobin, the oxygen carrying protein.

Explanation

Learning Outcomes

Polycythemia is a disorder in which hematocrit and hemoglobin are elevated due to an increased number of red blood cells. Polycythemia may be a primary disorder or secondary to a disease process that causes hypoxemia. An increase in the number of red blood cells is the body’s attempt to compensate for hypoxemia by producing more oxygen carrying red blood cells. Polycythemia is common in client with COPD as a compensatory mechanism for prolonged, severe hypoxemia.

Test Taking Tip

Answer choices #1 & 2 are very similar as they both refer to anemia. Typically when there are two very similar answer choices, they may be eliminated as possibilities.

Video Rationale