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Alterations
in Oxygen Transport

Deb Smith, age fifty-six, came to her nurse practitioner (NP) with
fatigue, pallor, dyspnea on exertion, and palpitations. Her laboratory report
indicates that her hematocrit, hemoglobin, and reticulocyte counts are low;
that her MCV is high; and that her MCH and MCHC are normal. Her diagnosis is
pernicious anemia.

Answer the following questions regarding Deb’s anemia and provide
the pathophysiology associated with the body’s response to this disease process.

· Why
should Deb’s NP ask her about paresthesia and ataxia?

o Why
did her NP prescribe vitamin B₁₂ by intramuscular injection
rather than orally?

o What
causes pernicious anemia?

o What
are the technical terms that describe an anemia with high MCV and normal MCH?