A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8-pound weight loss since admission. What condition does the nurse expect the client to be tested for?

Reasoning:

Choice A reason: Infection is not directly related to tissue hypoxia in iron deficiency anemia. Hypoxia results from low hemoglobin, reducing oxygen delivery, but it does not inherently cause infection. Infections may contribute to anemia in chronic disease but are not the primary issue in iron deficiency.

Choice B reason: Deficient fluid volume is not a primary concern in iron deficiency anemia. Impaired erythropoiesis reduces red blood cell production due to low iron, causing anemia, but fluid volume remains normal unless bleeding occurs. Fatigue from low oxygen capacity is more directly linked to the condition.

Choice C reason: Acute pain is not typical in iron deficiency anemia. Pain is associated with hemolytic anemias like sickle cell disease due to vaso-occlusion. Iron deficiency causes fatigue and dyspnea from low hemoglobin, not hemolysis or pain, making this an incorrect association.

Choice D reason: Fatigue related to decreased oxygen-carrying capacity is the most likely issue in iron deficiency anemia. Low iron impairs hemoglobin synthesis, reducing red blood cell oxygen transport, causing tissue hypoxia and fatigue, especially during exertion, directly reflecting the pathophysiology of the client’s condition.

Reasoning:

Choice A reason: Sickle cell anemia is an inherited disorder caused by a genetic mutation in the hemoglobin gene, leading to abnormal hemoglobin (HbS). This causes red blood cells to sickle under stress, triggering hemolysis. The autosomal recessive inheritance pattern makes it a classic example of an inherited hemolytic anemia with chronic hemolysis.

Choice B reason: Hypersplenism is not an inherited disorder but a condition where an enlarged spleen sequesters and destroys red blood cells, causing anemia. It results from secondary causes like liver disease or portal hypertension, not genetic mutations, making it an acquired cause of hemolytic anemia.

Choice C reason: Cold agglutinin disease is typically acquired, often due to infections or autoimmune disorders, causing antibodies to agglutinate red blood cells at low temperatures, leading to hemolysis. While rare congenital forms exist, it is not primarily inherited, unlike sickle cell anemia’s genetic basis.

Choice D reason: Autoimmune hemolytic anemia is usually acquired, caused by autoantibodies attacking red blood cells, leading to hemolysis. It is associated with conditions like lupus or infections, not genetic mutations. Unlike sickle cell anemia, it lacks an inherited genetic component as its primary etiology.