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Red Blood Cell Count
- Refers to the number of RBCs per cubic millimeter (mm3) of blood.
- Requires no special patient preparation.
- Requires 1 mL of venous blood.
Reference values:
|
Men
Women |
4.6 – 5.9 million/mm3
4.2 – 5.4 million/mm3 |
|
Pregnancy |
Slightly lower |
|
Newborn |
5.5 – 6 |
|
Children |
4.6 – 4.8 |
Increased RBC Count
Also know as Polycythemia or Erythrocytosis may indicate:
- Physiologic increases related to oxygen need:
- A move to an area of high altitude. Why? There is less oxygen at higher altitudes therefore production of red blood cells is increased by the bone marrow. Your body is responding to a need for oxygen.
- Increased physical training. Why? Training increases muscle mass and more muscle requires more oxygen.
- Pathologic increases:
- Primary Polycythemia: Refers to the disease called polycythemia vera (true) which is not caused by oxygen need but for example may be related to overactive bone marrow.
- Treatment: Slow the bone marrow with radioactive phosphorus.
- Secondary Polycythemia: Is related to chronic hypoxia such as seen with chronic lung disease or children with congenital heart disease.
- Treatment: If possible correct the cause of hypoxia.
- Nursing considerations:
- Here the blood becomes more viscous making the patient susceptible to formation of venous thrombi.
- Therefore it is important to maintain adequate hydration.
- Example: 2000 mL per day for an adult.
- HOWEVER be sure to assess your patients overall status carefully, patients with heart defects and chronic lung disease may be nearing a state of congestive heart failure!
- It is important patients not become dehydrated. Consider this when NPO is ordered for extended periods of time.
Decreased RBC Count
May indicate:
- Abnormal loss of erythrocytes.
- Abnormal destruction of erythrocytes.
- Lack of necessary elements or hormones needed for erythrocyte production.
- Bone marrow suppression.
Anemia refers to a decrease in the total number of RBCs, or hgb of RBCs, or both dependant upon the classification of anemia.
Other information:
- Erythropoietin, a hormone secreted chiefly by the kidneys stimulates RBC production.
- Erythropoietin production is increased by tissue hypoxia.
- Reference values increase at high altitudes.
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