Fundamentals of Nursing Q 126
An adult male client has a hemoglobin count of 12.5 g/dL. Based on the result, the client is most likely having this due to which of the following notes in the client’s record?
A. Emphysema.
B. Client living at a high altitude.
C. Dehydration.
D. History of an enlarged spleen.
Correct Answer: D. History of splenomegaly.
The normal hemoglobin level for an adult male is 14-16.5 g/dL. An enlarged spleen may cause anemia (low hemoglobin count) in clients. The spleen normally removes old and/or damaged red blood cells from the bloodstream. However, when the spleen enlarges, it traps and stores an excessive number of red blood cells, causing anemia. Sometimes, the spleen also destroys white blood cells and/or platelets causing a low white blood cell count (leukopenia) and a low platelet count (thrombocytopenia).
Option A: Anemia of chronic disease (ACD) is probably the most common type of anemia associated with COPD. ACD is driven by COPD-mediated systemic inflammation. Anemia in COPD is associated with greater healthcare resource utilization, impaired quality of life, decreased survival, and a greater likelihood of hospitalization.
Option B: Living at higher altitudes causes red blood cell production to naturally increase to compensate for the lower oxygen supply. The amount of hemoglobin in blood increases at high altitude. This is one of the best-known features of acclimatization (acclimation) to high altitude. Increasing the amount of hemoglobin in the blood increases the amount of oxygen that can be carried.
Option C: Dehydration may increase the hemoglobin level by hemoconcentration. Both the hemoglobin and the hematocrit are based on whole blood and are therefore dependent on plasma volume. If a patient is severely dehydrated, the hemoglobin and hematocrit will appear higher than if the patient were normovolemic; if the patient is fluid overloaded, they will be lower than their actual level.