Variations in staining, color, shape, and RBC inclusions are indicative of RBC abnormalities (Table 2.5).
Clinical Alert
Marked abnormalities in size and shape of RBCs without a known cause are an indication for more complete blood studies
The stained film examination determines variations and abnormalities in erythrocyte size, shape, structure, Hb content, and staining properties. It is useful in diagnosing blood disorders such as anemia, thalassemia, and other hemoglobinopathies. This examination also serves as a guide to therapy and as an indicator of harmful effects of chemotherapy and radiation therapy. The leukocytes are also examined at this time.
Size: normocytic (normal size, 7–8 μm)
Color: normochromic (normal)
Shape: normocyte (biconcave disk)
Structure: normocytes or erythrocytes (anucleated cells)
Collect 5 mL of whole blood in a lavender-topped tube (with EDTA). Label the specimen with the patient’s name, date and time of collection, and test(s) ordered. Stain a thin smear with Wright stain and study under a microscope to determine size, shape, and other characteristics of the RBCs.
Be aware that a capillary smear may also be used and may be preferred for detection of some abnormalities.
Variations in staining, color, shape, and RBC inclusions are indicative of RBC abnormalities (Table 2.5).
Clinical Alert
Marked abnormalities in size and shape of RBCs without a known cause are an indication for more complete blood studies
Pretest Patient Care
Explain the purpose and procedure for testing. Assess for possible causes of anemia. No fasting is required.
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.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.