A nurse assesses a patient with renal insufficiency and a low red blood cell count.
The patient asks, "Is my anemia related to my kidney problem?". Which statement would serve as the basis for the nurse's response?
Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
Your anemia and kidney problem are related to inadequate vitamin D and a loss of bone density.
Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.
The Correct Answer is C
Choice A rationale
Red blood cells are produced in the bone marrow, not the kidneys, and they do not produce erythropoietin. Erythropoietin is a hormone primarily produced by the kidneys in response to tissue hypoxia, which stimulates the bone marrow to produce red blood cells, thus increasing the oxygen-carrying capacity of the blood.
Choice B rationale
Anemia in renal insufficiency is not primarily related to vitamin D deficiency or bone density loss. While kidney disease can affect vitamin D activation and calcium-phosphate balance, the main cause of anemia in this context is the decreased production of erythropoietin by the failing kidneys.
Choice C rationale
The kidneys are the primary producers of erythropoietin in the body. When kidney function is compromised, this production is significantly reduced, leading to inadequate stimulation of the bone marrow. This results in decreased red blood cell production, causing the anemia commonly seen in patients with chronic renal insufficiency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A severe allergy to shellfish and iodine is associated with thyroid dysfunction, not gonadotropin-releasing hormone (GnRH) deficiency. Iodine is a crucial component for the synthesis of thyroid hormones T3 and T4, and its deficiency or allergic reaction could impair thyroid function. However, this allergy has no direct physiological link to the hypothalamic-pituitary-gonadal axis which regulates GnRH secretion.
Choice B rationale
Long-term use of oral contraceptives can suppress the hypothalamic-pituitary-ovarian axis by providing exogenous estrogen and progesterone, which exerts a negative feedback on the pituitary gland and hypothalamus. This can lead to a reduction in endogenous GnRH, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) secretion, but it is not considered a permanent deficiency and function typically returns after discontinuation of the medication.
Choice C rationale
The hypothalamus is a part of the brain that is responsible for producing gonadotropin-releasing hormone (GnRH). Head trauma can cause damage to the hypothalamus or the pituitary stalk, which connects the hypothalamus to the pituitary gland. This damage can disrupt the pulsatile release of GnRH, leading to secondary hypogonadism, making head trauma a significant risk factor for GnRH deficiency.
Choice D rationale
Adult-onset diabetes mellitus, also known as type 2 diabetes, is primarily related to insulin resistance and impaired insulin secretion from the pancreas. While it can have systemic effects and is associated with various other endocrine disorders, it does not directly cause a deficiency of gonadotropin-releasing hormone. GnRH deficiency is more commonly linked to central nervous system pathology.
Correct Answer is C
Explanation
Choice A rationale
Numbness and tingling around the mouth, or perioral paresthesia, is a classic sign of hypocalcemia, not a symptom to be addressed with mouth care. Offering mouth care would not address the underlying physiological issue, which is a potential disturbance in calcium levels due to accidental removal of or damage to the parathyroid glands during thyroidectomy, a serious and life-threatening complication.
Choice B rationale
Assessing for orientation would be an inappropriate action because the patient's symptoms are physical, not neurological, and do not suggest a change in mental status. The numbness and tingling are a specific finding pointing to a possible parathyroid gland injury and subsequent hypocalcemia. The nurse must prioritize assessment and intervention related to this critical electrolyte imbalance.
Choice C rationale
Muscle twitching, or neuromuscular excitability, is a hallmark sign of severe hypocalcemia. The numbness and tingling around the mouth are early indicators, and checking for muscle twitching, such as Chvostek's or Trousseau's sign, would further confirm the suspected diagnosis. This assessment is a critical and immediate step to evaluate the severity of the electrolyte imbalance and guide appropriate intervention.
Choice D rationale
Loosening the dressing is an action for a patient experiencing symptoms of a hematoma or airway compression, such as difficulty breathing or swelling. The patient's symptom of perioral paresthesia is related to a metabolic disturbance (hypocalcemia) and is not a sign of physical compression. Therefore, loosening the dressing would not alleviate this symptom and is an incorrect intervention.
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