Overview

1. Red blood cells
   1. Normal Value Range
   2. Patho
   3. Special considerations
   4. Too High: Causes, Symptoms, Treatments
   5. Too Low: Causes, Symptoms, Treatments

Nursing Points General

1. Normal range
   1. Measured in millions
   2. Normal values
      1. Males 4.5-5.5 x106/mcL
      2. Females 4-4.9×106/mcL
2. Pathophysiology
   1. Red Blood Cell generation
      1. Formed in bone marrow
      2. Stimulated by kidneys by erythropoietin
   2. Function
      1. AKA Erythrocytes
         1. Reticulocytes
            1. Young RBC
            2. Indicate regeneration
      2. Carries oxygen
         1. Via Hemoglobin
         2. Allows for transfer of CO2
      3. Bioconcave shape
         1. Increases surface area
         2. Allows for ability to “squeeze” into capillaries
      4. 2.4 M made every 1 second
3. Special considerations
   1. Submitted via LAVENDER top tube (EDTA)
   2. Technique can destroy red blood cells
      1. Allow vacuum in vacutainers to draw blood, never force blood into tubes
      2. Consider angiocath/IV size when drawing blood
4. Elevated RBC results
   1. Dehydration
      1. Result of decreased plasma
   2. Polycythemia
      1. Bone marrow cancer, causes increase in RBC
   3. COPD
   4. Pulmonary fibrosis
5. Decreased RBC results
   1. Anemia
      1. Sickle-cell
      2. ↓ EPO due to kidney disease
   2. Hemorrhage
   3. Bone marrow failure
   4. Pregnancy

Assessment

1. Assess for signs of anemia
   1. Tachycardia
   2. Fatigue
   3. Shortness of breath
   4. Decreased SaO2
   5. Pallor

Therapeutic Management

1. Blood transfusions as necessary
2. Treat primary cause of anemia

Nursing Concepts

1. Lab Values
2. Oxygenation