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Introduction ⬇

The MCHC measures the average concentration of Hb in the RBCs. The MCHC is most valuable in monitoring therapy for anemia because the two most accurate hematologic determinations (Hb and Hct) are used in its calculation.

Normal Findings ⬆ ⬇

32–36 g/dL or 4.9–5.5 mmol/L

Procedure ⬆ ⬇

  1. The MCHC is a calculated value. It is an expression of the average concentration of Hb in the RBCs and, as such, represents the ratio of the weight of Hb to the volume of the erythrocyte.

  2. Use the following formula:

Clinical Implications ⬆ ⬇

  1. Decreased MCHC values signify that a unit volume of packed RBCs contains less Hb than normal. Hypochromic anemia (MCHC <30 g/dL) occurs in:

    1. Iron-deficiency anemia

    2. Microcytic anemias, chronic blood loss anemia

    3. Some thalassemias

  2. Increased MCHC values (RBCs cannot accommodate >37 g/dL or 370 g/L Hb) occur in:

    1. Spherocytosis (hereditary)

    2. Newborns and infants

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain test purposes and procedures.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. 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.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Interfering Factors ⬆

  1. The MCHC may be falsely high in the presence of lipemia, cold agglutinins, or rouleaux and with high heparin concentrations.

  2. The MCHC cannot be more than 37 g/dL (370 g/L) because the RBC count cannot accommodate more than 37 g/dL (370 g/L) Hb. (Check for errors in calculation or in Hb determination. MCHC can be used for laboratory quality control.)