A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse’s best understanding of how anemias are classified, based on the deficiency of erythrocytes? (Select all that apply)

Defective production of erythrocytes

Destruction of erythrocytes

Loss of erythrocytes

Shape of erythrocytes

Quantity of erythrocytes

Answer and Explanation

Correct Answer : A,B,C

Reasoning:

Choice A reason: Defective production of erythrocytes is a key classification of anemia, as seen in conditions like aplastic anemia or iron deficiency anemia. Impaired bone marrow function or nutrient deficiencies reduce red blood cell synthesis, leading to decreased hemoglobin and oxygen-carrying capacity, a common mechanism in various anemias.

Choice B reason: Destruction of erythrocytes, or hemolysis, is a major anemia classification. Conditions like hemolytic anemia cause premature red blood cell breakdown due to immune-mediated destruction, membrane defects, or hemoglobinopathies, reducing circulating erythrocytes and causing anemia despite normal or increased bone marrow production.

Choice C reason: Loss of erythrocytes through bleeding is a primary anemia classification. Chronic or acute blood loss from gastrointestinal, genitourinary, or traumatic sources depletes red blood cells and iron stores, leading to iron deficiency anemia, a common cause, particularly in older adults or those with chronic bleeding.

Choice D reason: Shape of erythrocytes is not a primary classification for anemia. While abnormal shapes, like sickle cells, contribute to specific anemias (e.g., sickle cell anemia), classification focuses on mechanisms like production, destruction, or loss. Shape is a characteristic, not a primary cause of anemia.

Choice E reason: Quantity of erythrocytes is a consequence, not a classification, of anemia. All anemias involve reduced erythrocyte counts, but the classification is based on underlying causes—defective production, destruction, or loss—not the resulting low quantity, which is a defining feature rather than a mechanistic category.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Thiazide diuretics reduce urine output in nephrogenic diabetes insipidus by increasing sodium excretion, which enhances water reabsorption indirectly. However, they are not the primary treatment for central diabetes insipidus, where ADH deficiency is the issue. Desmopressin, an ADH analog, directly addresses the hormonal deficiency, making thiazides less effective.

Choice B reason: Diabinese (chlorpropamide) is a sulfonylurea used for type 2 diabetes mellitus, not diabetes insipidus. It lowers blood glucose by stimulating insulin release, which is irrelevant to the water balance issue in diabetes insipidus caused by ADH deficiency. It does not address the underlying hormonal imbalance.

Choice C reason: Desmopressin (DDAVP) is a synthetic ADH analog used to treat central diabetes insipidus. It mimics ADH, promoting water reabsorption in the kidneys’ collecting ducts, reducing polyuria and thirst. This directly corrects the fluid imbalance caused by ADH deficiency, making it the primary and most effective treatment.

Choice D reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, is used for pain and inflammation, not for fluid balance in diabetes insipidus. It has no effect on ADH or renal water reabsorption, making it irrelevant for treating the excessive urine output and dehydration associated with this condition.

A. Diabetes insipidus (DI) B. Pituitary tumor C. Hypothyroidism D. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Diabetes insipidus is likely due to the client’s symptoms of polyuria, thirst, and weight loss following a head injury. Trauma can disrupt the posterior pituitary, reducing ADH secretion, leading to excessive dilute urine output, dehydration, and subsequent thirst and weight loss from fluid depletion, consistent with central DI.

Choice B reason: A pituitary tumor may cause diabetes insipidus but is not the condition itself. Tumors can disrupt ADH production, but the symptoms described—polyuria, thirst, and weight loss—point directly to diabetes insipidus as the primary condition, with a tumor being a potential underlying cause requiring further investigation.

Choice C reason: Hypothyroidism, caused by thyroid hormone deficiency, leads to symptoms like fatigue and weight gain, not polyuria or weight loss. It is unrelated to head injury or ADH dysfunction, making it an unlikely diagnosis for the client’s symptoms of excessive urine output and dehydration.

Choice D reason: SIADH causes water retention, leading to concentrated urine, hyponatremia, and potential weight gain, opposite to the client’s symptoms of dilute urine, weight loss, and thirst. Head injury may cause SIADH, but the clinical presentation aligns with diabetes insipidus, not water retention.

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A nurse cares for several clients with anemia and notes that all the clients have different types of anemia. What is the nurse’s best understanding of how anemias are classified, based on the deficiency of erythrocytes? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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