Description

Overview

1. Hematocrit
   1. Normal Value Range
   2. Pathophysiology
   3. Special considerations
   4. Elevations in lab results
   5. Decreased HCT levels

Nursing Points

General

1. Normal value range
   1. HCT measured in percentage
   2. Males – 41-50%
   3. Females – 36-44%
2. Pathophysiology
   1. Measurement of total pRBCs compared to rest of blood volume
   2. Helps to indicate anemia
   3. Often measured with HGB (hemoglobin)
3. Special considerations
   1. Lavender top tube (EDTA)
   2. Be cautious with technique
      1. Do not force sample into tube
      2. Can cause hemolysis
      3. Alters results
4. Causes of HCT elevation
   1. Dehydration
      1. Change in % compared to total blood volume
   2. Respiratory disease
      1. COPD
      2. Pulmonary fibrosis
         1. Increased need for oxygen -> increased need for RBC production
   3. Polycythemia vera
      1. RBC overproduction due to bone marrow cancer
      2. Treatment includes bloodletting and increasing water consumption (also some medications)
5. Causes of decreased HCT
   1. Blood loss
      1. Trauma
      2. Hemorrhage
      3. Treatment
         1. Stop bleeding
         2. Transfuse blood
   2. Anemia
      1. Kidney disease
         1. Decrease in EPO production
         2. Treatment
            1. Supplement with EPO
      2. Pregnancy
         1. Relative to increase total blood volume
   3. Leukemia
      1. Decreased bone marrow production causes ↓ RBC
      2. Treat leukemia via oncology pathways
         1. Chemotherapy
         2. Radiation
         3. Bone marrow transplant

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
3. Use oncologic methods to treat leukemia
4. Bloodletting (phlebotomy) for polycythemia patients

Nursing Concepts

1. Lab Values
2. Oxygenation