The nurse is teaching a class on how red blood cell formation is ...

[P68T]

The nurse is teaching a class on how red blood cell formation is regulated by the body to a group of clients who have AIDS. The nurse evaluates that learning has occurred when the clients make which statements?
 
  1. Red blood cell formation is regulated through chemicals called colony-stimulating factors that come from white blood cells.
  2. Red blood cell formation is regulated through messages from the hormone, secretin, which is located in the kidney.
  3. Red blood cell formation is regulated through specific liver enzymes and a process called hemochromatosis.
  4. Red blood cell formation is regulated through messages from the hormone erythropoietin.
  5. Red blood cell formation is regulated through specific transporter proteins called apolipoprotein A and B.

Question 2

The client receives epoetin alfa (Epogen) subcutaneously, and says to the nurse, My doctor said I have anemia. Are there little red blood cells in that shot? What are the best responses by the nurse?
 
  1. Your kidney makes more erythropoietin if it doesn't get enough oxygen.
  2. Erythropoietin also helps your body make hemoglobin.
  3. This stimulates your kidney to make more red blood cells.
  4. It is similar to a kidney hormone, erythropoietin, and helps your body make more red blood cells.
  5. Your kidney makes more erythropoietin when you have too much fluid in your body.

[amy.lauersdorf90]

Answer to Question 1

Correct Answer: 4
Rationale 1: Colony-stimulating factors affect white blood cell production.
Rationale 2: Secretin stimulates the pancreas to release a fluid that neutralizes stomach acid and aids in digestion; it has nothing to do with red blood cell formation.
Rationale 3: Hemochromatosis refers to excess iron accumulation in the body, not to red blood cell formation.
Rationale 4: Regulation of hematopoiesis occurs through messages from hormones such as erythropoietin.
Rationale 5: Apolipoprotein refers to a protein found in cholesterol particles; it has nothing to do with red blood cell formation.

Answer to Question 2

Correct Answer: 1,2,4
Rationale 1: Erythropoiesis is regulated by the kidney hormone, erythropoietin. The primary signal for increased secretion is a reduction in oxygen reaching the kidney.
Rationale 2: This hormone reacts with receptors on hematopoietic stem cells to increase erythrocyte production. It also stimulates production of hemoglobin.
Rationale 3: Red blood cells are manufactured in the bone marrow, not in the kidney.
Rationale 4: Epoetin alfa is identical to the natural hormone erythropoietin and stimulates the production of red blood cells in the same manner.
Rationale 5: Reduced oxygen, not over-hydration is the stimulus for the kidney to produce additional erythropoietin.