Hemoglobin (Hbg) Lab Values

Overview Hemoglobin Normal Value Range Pathophysiology Special considerations Elevated hemoglobin Decreased hemoglobin Nursing Points General Normal value range Males – 13.5-16.5 g/dL Females – 12.0 – 15.0 g/dL Pathophysiology Protein attached to red blood cell Iron based protein 4 groups 2 alpha 2 beta Has a high affinity (attraction) for oxygen Oxyhemoglobin Has oxygen attached Deoxyhemoglobin Oxygen has been released Oxyhemoglobin Dissociation Curve Oxygen saturation Shift to the right Partial pressure is higher HGB attraction to oxygen is lower Oxygen becomes less “sticky” and wants to be released Causes ↓pH ↑pCO2 ↑Temperature Shift to the left Partial pressure is lower HGB attraction is higher Oxygen wants to stay “stuck” to HGB Causes ↑pH ↓pCO2 ↓Temperature Special considerations Submit in lavender top tube Be cautious with phlebotomy technique Reduce hemolysis with proper tubing and syringes Elevated HGB values Polycythemia vera Treatments Blood letting Increased water intake Some medications Dehydration Lung disease Pulmonary fibrosis COPD Certain medical therapies EPO supplementation Decreased HGB values Thalassemia Blood loss Sickle Cell anemia Aplastic anemia Cancers Assessment Assess for signs of anemia Tachycardia Fatigue Shortness of breath Decreased SaO2 Pallor Therapeutic Management Blood transfusions as necessary Treat primary cause of anemia Nursing Concepts Lab Values Oxygenation