The RBC indices define the size and Hb content of the RBC count and consist of the MCV, the MCHC, and the MCH.
The RBC indices are used in differentiating anemias. When they are used together with an examination of the erythrocytes on the stained smear, a clear picture of RBC morphology may be ascertained. On the basis of the RBC indices, the erythrocytes can be characterized as normal in every respect or as abnormal in volume or Hb content. In deficient states, the anemias can be classified by cell size as macrocytic, normocytic, or microcytic, or by cell size and color as microcytic hypochromic.
These are calculated values.
Obtain 5 mL of whole blood in a lavender-topped tube (with EDTA) so that RBC count, Hb, and Hct determinations can be performed. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered.
Pretest Patient Care for MCV, MCHC, and MCH
Explain the purpose and procedure for testing. Assess for possible causes of anemia. No fasting is required. Assess for signs/symptoms of fatigue, palpitations, dyspnea, angina, tachycardia, brittle hair and nails, and pallor.
Follow guidelines in Chapter 1 for safe, effective, informed pretest care.
Posttest Patient Care for MCV, MCHC, and MCH
Review test results; report and record findings. Modify the nursing care plan as needed.
Counsel the patient appropriately for proper diet, medication, related hormone and enzyme problems, and genetically linked disorders. Explain the need for possible follow-up testing and treatment.
Treatment includes iron-rich foods, control of chronic blood loss, or administration of iron.
Follow guidelines in Chapter 1 for safe, effective, informed posttest care.