Why are my pt.'s RBC, Hgb, Hct low?

[ilearntoo]

I can't seem to link my pt.'s labs together with her condition. Pt. dx with pelvic abscess. e.coli present in abscess. WBC elevated: I know because of the infection WBC increased to fight off the infection. As for RBC, Hgb, HcT low: pt. not dx anemia, sats are good at 97 consecutively. No signs of hemorrhage, no mentions of internal bleeding by anyone or on chart. I'm lost. I don't know why she has low labs. I understand it means oxygen is not being carried to places or there are not enough blood cells to carry them, but pt. has no s/s of anything oxygen related wrong. She's on no oxygen (nasal cannula, etc.) either.

I'm a nursing student working on my careplan. :s

Thanks in advance!

[Stcroix, ASN, PhD, RN]

how is her kidney function? older people often have kidney issues, low function will often cause low levels of [color=#333333]erythropoietin, which will cause low hematocrit.

[nurseprnRN, BSN, RN]

do not use the term "blood thinner," even though you hear physicians say it to patients all the time. it puts people in mind of water in the milk or turpentine in the paint. if her blood was really being thinned, her crit would be diluted, but anticoagulants do not do that. patients can understand the word "clot" and the words to describe the medication as " makes your blood clot more slowly." if they understand that then they will understand your teaching them about watching for signs of bleeding, bruising, and black stools in a way that "thin blood" can't begin to communicate.

ahem. off soapbox.

she might also have anemia of chronic disease, if she's been sick a long time. she could also just have old bone marrow and not be able to make rbcs as well. at the moment my money is on anemia (maybe due to bleeding in her gut somewhere) with dehydration preadmission, and then dilutional drop in crit due to restoration of intravascular volume. but since she is on anticoagulants, keep an eye on that crit.