CASE STUDY A 22-year-old woman was admitted froes the emergency department for tests. She had fever, dysuria, and lower back pain. Immediate laboratory results revealed the fol lowing: CBC Urinalysis 4+ urine protein 1+ Hgb Many bacteria Moderate blood Moderate WBC Casts: few hyaline, few granular Chemistry: WBC:11.8 X 10P/L RBC, 29 x 1012/1 Hgh: 8.3 g/dL Het: 255 MCV: 88 L MCH: 29 PB BUN: 113 mg/dL Creatinine: 7.7 mg/dL MCHC: 300 L or 305 RDW: 14.79 1+ aniso 1+ poik 1 + crenated RBCS Blood cultures were drawn and eventually produced coagulase negative Staphylococcus. Blood was still present in the patient’s urine after 2 days, and bleeding was noted from intravenous infusion sites. Coagulation tests were ordered before the patient was to go to surgery for kidney biopsy. Platelet count: 296 X 10P/L PT: 11.7 seconds (control: 10.0-12.9 seconds) APTT: 32 seconds (control: 23-35 seconds) Bleeding time: > 20 seconds FDP: > 40 ug/mL (APTT is activated partial thromboplastin time: FDP means fibrin/fibrinogen degradation products.) This patient was suffering from bacterial sepsis and renal failure. The admitting CBC demonstrated a mild anemia with some created red cell morphology typical of renal disease. The patient had received several units of packed red cells with no noticeable difference in her hematocrit (Hct). The anemia could be the product of several mechanisms. First, there was blood loss from her abnormal platelets (see Chap. 23) and from the DIC that she later developed. Her presenting anemia was most likely a result of the anemia of inflammation. Chronie and acute infections can produce this form of anemia The anemia of renal disease was also present in this pa- tient and was seen in conjunction with other causes of anemia Questions 1. Classify the anemia with regard to RBC indices. 2. Explain the significance of the RDW value in this case 3. List the laboratory parameters in this case that coincide with anemia associated with renal disease. 4. What is the major cause of renal failure associated with anemia? 5. Why would chronic iron loss be a concer in this patient?
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https://nursingpaperspros.com/wp-content/uploads/2020/05/logo-nursing--300x60.png00Hectorhttps://nursingpaperspros.com/wp-content/uploads/2020/05/logo-nursing--300x60.pngHector2020-06-07 19:54:082020-06-07 19:54:08What is the major cause of renal failure associated with anemia?
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