After major surgery, a client's hemoglobin is 9.6 gm/dL. The nurse expects that the client's erythropoietin output would go up, but recognizes that increased production is largely dependent on which factor?
1. Resumption of regular and balanced dietary intake
2. Normal kidney function
3. Normal bone marrow function
4. Normal serum ferritin levels
Correct Answer: 2
Rationale 1: Dietary intake of iron supports the construction of the core of the hemoglobin molecule. Amino acids are needed to form the erythropoietin molecule, but dietary intake in itself does not have major effects on the increase in the hormone level.
Rationale 2: The bone marrow is stimulated by erythropoietin from the kidney.
Rationale 3: Bone marrow responds to the stimulus of erythropoietin; it does not produce erythropoietin.
Rationale 4: Iron is needed to make red blood cells, but its absorption is not driven by erythropoietin.
Global Rationale: The bone marrow is stimulated by erythropoietin from the kidney. Dietary intake of iron supports the construction of the core of the hemoglobin molecule. Amino acids are needed to form the erythropoietin molecule, but dietary intake in itself does not have major effects on the increase in the hormone level. Bone marrow responds to the stimulus of erythropoietin; it does not produce erythropoietin. Iron is needed to make red blood cells, but its absorption is not driven by erythropoietin.
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