Which finding would the nurse expect to see in a patient with a hemoglobin level of 8 g/dL? Select all that apply.
One, some, or all responses may be correct.

Choice A rationale:

Neutropenia is a condition characterized by a low number of neutrophils, a type of white blood cell. Neutropenic patients are at increased risk of infections, but neutropenia does not cause specific changes in the tongue surface. The smooth and shiny tongue surface described in the question is not indicative of neutropenia.

Choice B rationale:

Polycythemia is a condition characterized by an abnormally high concentration of hemoglobin in the blood. It can cause the skin to appear reddish or flushed, but it does not directly cause changes in the tongue surface such as smoothness and shininess.

Choice C rationale:

Pernicious anemia is a type of anemia caused by a deficiency of vitamin B12, which is essential for the formation of red blood cells and the maintenance of the nervous system. One of the characteristic signs of pernicious anemia is glossitis, which is inflammation of the tongue that can make the tongue appear smooth and shiny. This finding aligns with the description provided in the question.

Choice D rationale:

Elevated estrogen levels can cause changes in the skin, such as increased pigmentation or the development of spider veins, but they do not directly cause changes in the tongue surface as described in the question.

Choice A rationale:

Stenosis of the heart valves typically leads to murmurs and changes in heart sounds but does not directly impact blood pressure regulation.

Choice B rationale:

Decreased adrenergic sensitivity might lead to lower heart rate and blood pressure, not an increase in systolic blood pressure as seen in this case.

Choice C rationale:

Increased parasympathetic activity would lead to decreased heart rate, not an increase in systolic blood pressure as observed in the patient.

Choice D rationale:

Loss of elasticity in arterial vessels is the correct answer. With aging, arterial walls become less flexible and more rigid due to the accumulation of calcium and collagen. This loss of elasticity results in increased systolic blood pressure, which is the top number in a blood pressure reading. The diastolic pressure, represented by the bottom number, does not usually increase significantly with age. This change is a result of arteriosclerosis, which commonly occurs in elderly individuals.