NR 507 Week 2 Edapt; Hematology

Blood circulation is necessary to transport substances required for tissue cellular metabolism, eliminate metabolic waste products, provide defense against invading microorganisms and injuries, and regulate acid-base balance. Anemia is a disorder characterized by a deficiency in the number of red blood cells or a decrease in the quantity of hemoglobin in the blood. Red blood cells and hemoglobin are crucial for transporting oxygen from the lungs to the body's tissues and organs. Oxygen Transportation From tissues O2 binds to hemoglobin and CO2 released for exhaling Pulmonary alveolus Hemoglobin in red blood cells (RBCs) transports O2 to tissues Hemoglobin O2 molecule O2 released to cells and CO2 absorbed to be carried back to lungs To lungs Anemia is a reduction in the oxygen-carrying capacity of blood due to a lack of circulating red blood cells or a decrease in the quality or quantity of hemoglobin. A normal hemoglobin level is 12.0–17.0 g/dL. The client has a low hemoglobin level; therefore, the NP should expect the client to exhibit clinical manifestations of anemia such as weakness, fatigue, pallor, muscle pain, increased respiratory rate, exertional dyspnea, dizziness, and fainting. Hypertension and bradycardia are not associated with anemia. When arterial oxygen levels are low, the kidneys increase production and excretion of erythropoietin to stimulate the bone marrow to increase red blood cell production. Red blood cells are produced within the bone marrow through the process of erythropoiesis: Decreased arterial oxygen levels results in tissue hypoxia. Tissue hypoxia stimulates the kidneys to increase production and excretion of erythropoietin. Erythropoietin binds to erythropoietin receptors in the bone marrow, resulting in increased production of red blood cells. An increase in red blood cells often corrects tissue hypoxia. Improved tissue hypoxia signals the kidneys to reduce production and excretion of erythropoietin to a normal level. When the serum erythropoietin level is high, it is anticipated that the hematocrit will be low, and when the serum erythropoietin level is low, it is anticipated that the hematocrit will be high. Increased production and excretion of erythropoietin is stimulated by tissue hypoxia, associated with low hemoglobin and hematocrit levels. When hemoglobin and hematocrit levels are normal, the production and excretion of erythropoietin returns to normal levels. When hemoglobin and hematocrit levels are high, the production and excretion of erythropoietin is low. NORMAL RED BLOOD CELL PRODUCTION Erythrocytes are red blood cells that transport gas to and from the lungs and tissue cells. Adequate supplies of protein, vitamins, and minerals are necessary for normal erythrocyte production. Red blood cells are produced within the bone marrow through the process of erythropoiesis: Decreased arterial oxygen levels result in tissue hypoxia. Tissue hypoxia stimulates the kidneys to increase the production and excretion of erythropoietin. Erythropoietin binds to erythropoietin receptors in the bone marrow, resulting in increased production of red blood cells. An increase in the production of red blood cells often corrects tissue hypoxia. Improved tissue hypoxia signals the kidneys to reduce the production and excretion of erythropoietin to a normal level. Relationship between erythropoietin