On our careplans, we attempt to figure out why there are any abnormalities, and I stumped on this one...any input is appreciated:
Pt is 89 y/o Asian female, 85 pounds, no hx of anemia, only hx of HTN controlled with Toprol. She has hydronephrosis, and is schduled for surgery to remove pelvic tumors that have caused partial urinary obsturction on rt. side (however, the pt. maintained over 30ml/hl of output, due to having a stent placed in the rt. ureter) She presented with hematuria, in her UA it just stated "too numerous" under RBC's present
WBC:15.9, neutropjils 90 %, (although only trace bacteria was noted in her UA, white cells in UA was 5-10) She was receiving Levaquin and Vanc IV
H&H: 10.8, 32.2
Total Bili: 1.5
protein 62 g
She was malnourished, and on TPN regular lipids at 39 ml/hr with free water, via triple lumen subclavian.
She did not have FVE, so I am wondering why her H&H, and RBC's were low, and not her platelets? Would it have something to do with the production of erythpoiten impaired with the kidney? This one has stumped me, she did not have any other disease processes going, no chronice renal failure, dialysis, etc. She just had blood in her urine, but would it cause her counts in red to be that low with normal platelets?
Anyone feel like brainstorming?