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Running head: CASE STUDY 3 ANEMIA
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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
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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 oxygencarrying 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).
CASE STUDY 3 ANEMIA
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REFERENCES
Causes of Renal Failure & Anemia. (n.d.). Retrieved November 22, 2010, from eHow:
http://www.ehow.com/facts_5819989_causes-renal-failure-anemia.html
Liberator, M. B. (n.d.). Anemia of Chronic Renal Failure. Retrieved November 22, 2010, from
Nephrology: http://www.medstudents.com.br/nefro.nerfro4.htm
Porth, C. M., & Matfin, G. (2009). Pathophysiology Concepts of Altered Health States. China:
Lippincot Williams & Wilkins.