A nursing student asks a nurse why patients with chronic renal failure (CRF) have low erythrocyte counts. Which response by the nurse is correct?
a. "Damage to the renal tubules increases serum blood loss."
b. "Dialysis accelerates the breakdown of red blood cells."
c. "Erythropoietin is no longer produced by cells in the kidneys."
d. "Patients with CRF are deficient in iron, folic acid, and vitamin B12."
ANS: C
Erythropoietin is normally produced by peritubular cells in the proximal tubules of the kidneys, but it is not produced in patients with CRF. Erythropoietin stimulates red blood cell (RBC) production; therefore, when it is absent, RBC production is compromised. Blood loss in damaged renal tubules does not cause low blood counts in patients with CRF. Dialysis does not contribute to low blood counts. Patients with CRF are not more likely to be deficient in iron, folic acid, and vitamin B12.
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