RED BLOOD CELLS (RBC)

DEFINITION

Red blood cells (also referred to as erythrocytes) are the most common type of blood cell and
the vertebrate organism's principal means of delivering oxygen (O2) to the body tissues via the
blood flow through the circulatory system. They take up oxygen in the lungs or gills and release
it while squeezing through the body's capillaries.

 Total red blood cells

 The number of red cells is given as an absolute number per litre.
 Hemoglobin
 the iron-containing oxygen-transport metalloprotein in the red blood
cells of vertebrates[1] and the tissues of some invertebrates.
 Hemoglobin in the blood is what transports oxygen from the lungs or gills to the
rest of the body (i.e. the tissues) where it releases the oxygen for cell use.
 Expressed in grams per decilitre.
 Hematocrit or packed cell volume (PCV)
 This is the fraction of whole blood volume that consists of red blood cells.
 Red blood cell indices
 Using the results of RBC count, Hct and total Db test, RBC indices provide
important information about the size, HB concentration and HB weight of an
average RBC.

o Mean corpuscular volume (MCV) - the average volume of the red cells,
measured in femtolitres. Anemia is classified as microcytic or macrocytic based
on whether this value is above or below the expected normal range.
o Mean corpuscular hemoglobin (MCH) - the average amount of hemoglobin per
red blood cell, in picograms.
o Mean corpuscular hemoglobin concentration (MCHC) - the average
concentration of hemoglobin in the cells.

The RBC's are measured with four different tests, which are the
RBC count
hematocrit (HCT)
 hemoglobin (Hg)
 RBC indices

PURPOSE

 Help in classifying types of Anemia

 To provide data for calculating MCV and MCH
 Assess the blood oxygen capacity

NORMAL VALUES

 RBC count
o Male=4.7 to 6.1 million cells per microliter (cells/mcL)
o Female=4.2 to 5.4 million cells/mcL
 Hematocrit
o Male =42%-52%
o Female= 37-47%
  Hemoglobin
o Male=13.5-18 g/dl
o Female=12-16 g/dl
 RBC indices
o MCV = 76-100 micrometer
o MCH = 27-33 pg/cell
o MCHC = 32-36 g/dl

INDICATIONS

 hematologic disorders
 bleeding problems
 chronic anemias
 polycythemia
 patients undergoing chemotherapy or radiation therapy.

CONTRAINDICATIONS

 Fluid volume in the blood

 the blood sample should not be taken from an arm receiving IV fluid or during
hemodialysis

 It should be noted that pregnant women have extra fluid, which dilutes the blood
decreasing RBC levels

 Dehydration

ADVANTAGES

The tests can help to evaluate the number of RBC’s, diagnose anemia and other conditions
affecting red blood cells.

DISADVANTAGES

When the needle is inserted to draw blood, some people feel moderate pain, while others feel
only a prick or stinging sensation. Afterward, there may be some throbbing.

ABNORMAL RESULTS

Decreased RBC, Hct, Hb

 Trauma

 Burns

 Pregnancy

 Hemolytic anemia

 Hemorrhagic infections

 Gastrointestinal (GI) or other vascular bleed

  Iron deficiency anemia

 Vitamin B12 or folate deficiency

 Bone marrow damage

 Metabolic disorders

 Chronic inflammation

Increased RBC, Hct, Hb

 Dehydration

 Pulmonary disease

 Congenital heart disease

 Polycythemia vera

 Renal problems

 Over-transfusion of whole blood

 Tissue hypoxia

Decreased MCV (<76 micrometer)

 small (microcytic ) RBC’s suggests microcytic, hyochromic anemias caused ny iron

deficiency, pyridoxine-resposive anemia or thalassemia

Increased MCV ( >100 micrometer)

 large (macrocytic ) RBC’s suggests macrocytic anemias caused by megaloblastic

disorders, folic acid or Vit. B12 deficiency, inherited disorders of deoxyribonucleic acid synthesis
or reticulosytosis.

Decreased MCH (<27 pg) = haemoglobin deficiency

Increased MCH (>33 pg) = macrocytic cells with abnormally large volume of hemoglobin.

Increased MHCH (<32 g/dl) = hemoglobin deficiency

PATIENT PREPARATION

No special preparation is necessary.

NURSING RESPONSIBILITIES

1. Explain the importance of RBC count.

2. Tell the patient that a blood sample will be taken. Explain who will perform the
venipuncture and when will it be done.
3. Tell the patient the he doesn’t need to restrict food or fluids.