please help me firure out this RBC

[lillysa1919]

I'm doing my clinical paperwork and I cant figure this out...please help!!

Im on the cardiac floor

pt has:

DM

CVA x 3

MI

3 vessel disease

HTN

was on coumadin but stopped two days ago now on heparin

rbc 4.57 low 4.73 normal

hgb 13.3 low 13.7 low

hct 38.1 low 39.1 low

hasnt had any surgeries and im having a hard time finding out why is RBCs are low.. is there a relation with the cardiac that i am missing?? I just dont have much to go on with the RBC low one day and then normal the next.

Please help!!!!

[CynicallyVexed]

HTN/DM can lead to kidney damage resulting in low RBC.

Also Heparin could be playing a part in the low RBC H&H..

[lillysa1919]

I just wasnt sure with the rbcs only being low for that one day (but there is only two days of labs so i dont have much to go on ) and there isnt anything else to support kidney problems ....i hate getting stuck

[southern rn]

Even though your parameters show that this is low, I don't think it is enough to be of clinical signifance. Everyone's blood work isn't going to fall exactly into a category and it may mean absolutely nothing.

[Guillaume Colette]

[color=#990000]fall in hematocrit or blood pressure; guaiac-positive stools. notify physician if these occur

[nursej22, MSN, RN]

There are so many causes of anemia--with the limited info you have given, answering your question is hard.

Agree with the pp about DM and HTN causing anemia related to renal failure.

Labs may have changed because pt was diuresed, thus concentrating blood.

Many people have absorption problems like pernicious anemia, or have poor diets due to limited budgets.

Your pts other labs may give some clues: creatinine, MCV, MCH, MCHC, Iron, ferritin, TIBC, reticulocyte count, etc.

[morte, LPN, LVN]

how old is this patient?

[lillysa1919]

thanks for the help

[PostOpPrincess, BSN, RN]

In practical ap, these numbers aren't as relevant.