The nurse is assessing a patient being admitted with fatigue and shortness of breath as well as abdominal tenderness.The nurse notes that the patient is jaundiced; the physical examination reports an enlarged liver.The nurse suspects that the patient has

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Assessment of the patient with hemolytic anemia may reveal jaundice,abdominal pain,and enlargement of the spleen or liver.These findings result from the increased destruction of RBCs,their sequestration (abnormal distribution in the spleen and liver),and the accumulation of breakdown products.The patient with aplastic anemia may have bruising,nosebleeds,petechiae,and a decreased ability to fight infections.These effects result from thrombocytopenia and decreased WBC counts,which occur when the bone marrow fails to produce blood cells.Patients with sickle cell anemia may have joint swelling or pain,and delayed physical and sexual development.Decreased circulating volume is manifested by clinical findings reflective of low blood volume (e.g.,low right atrial pressure)and the effects of gravity on the lack of volume (e.g.,orthostasis).

The Nurse Is Assessing a Patient Being Admitted with Fatigue