Sulfhemoglobin is an abnormal Hb pigment produced by the combination of inorganic sulfides with Hb. Sulfhemoglobinemia is an excess of sulfhemoglobin that manifests as cyanosis. Sulfhemoglobinemia often accompanies drug-induced methemoglobinemia.
This test is indicated in persons with cyanosis. Sulfhemoglobinemia may occur in association with the administration of various drugs and toxins. The symptoms are few, but cyanosis is intense even though the concentration of sulfhemoglobin seldom exceeds 10%.
Draw a 5-mL venous blood sample using a lavender-topped (EDTA) tube. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered.
Place the specimen in a biohazard bag. Sulfhemoglobin is stable.
Sulfhemoglobin is observed in patients who take oxidant drugs such as phenacetin, acetaminophen, sodium bicarbonate, and citric acid (Bromo Seltzer), sulfonamides, and acetanilid (see Appendix E).
Sulfhemoglobin is formed rarely without exposure to drugs or toxins, as in chronic constipation and purging.
Sulfhemoglobin can be due to exposure to trinitrotoluene or zinc ethylene bisdithiocarbamate (fungicide).
Pretest Patient Care
Explain test purpose and procedure. Assess for exposure to drugs and toxins.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care
Review test results; report and record findings. Modify the nursing care plan as needed. Counsel the patient regarding abnormal findings; explain the need for possible follow-up testing and treatment. Explain the causes, signs, and symptoms of cyanosis and use of certain medications.
Sulfhemoglobin persists until the RBCs containing it are destroyed; therefore, the levels decline slowly over a period of weeks. There is no treatment.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.