Patho Patho #54

Question

A client with chronic renal insufficiency is anemic. What is the most likely explanation for this abnormality?

Answers

  1. 1. Poor activation of Vitamin D causes early death of RBCs.
    • Rationale:

      This answer choice is not correct because inadequate vitamin D deficiency does not lead to destruction of red blood cells.

  2. 2. Kidney disease causes anorexia leading to a poor diet.
    • Rationale:

      This answer choice is not correct because, although chronic renal disease causes a degree of anorexia, this is not the most important cause for anemia in these clients.

  3. 3. There is insufficient erythropoietin to stimulate RBC production.
    • Rationale:

      This answer is correct because erythropoietin is not produced in adequate amounts to stimulate new red blood cell production leading to the development of anemia in clients with renal insufficiency.

  4. 4. There is slow and continual bleeding of the damaged kidneys.
    • Rationale:

      This answer choice is not correct because renal insufficiency alone does not cause hemorrhage. Anemia of chronic renal disease is caused by inadequate erythropoietin production.

Overview

The focus of this question is asking the nurse to choose the most appropriate explanation for the development of anemia in clients with chronic renal insufficiency. The kidneys are responsible for the production of erythropoietin which stimulates red blood cell production. In clients renal insufficiency, erythropoietin production is not adequate which often results in anemia.

Explanation

Learning Outcomes

Erythropoiesis is the production of red blood cells. Erythropoietin is the hormone produced by the kidneys in response to low red blood cell counts which stimulates the production of new red blood cells. In clients with chronic renal insufficiency, erythropoietin production is not adequate to meet the demands for new red blood cell production which often leads to a chronic state of anemia.

Test Taking Tip

Procrit is synthetic erythropoietin given to chronic renal clients to help stimulate red blood cell production and improve anemia associated with renal insufficiency.

Video Rationale