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Introduction ⬇

The MCH is a measure of the average weight of Hb per RBC. This index is of value in diagnosing severely anemic patients.

Normal Findings ⬆ ⬇

26–34 pg/cell or 1.61–2.11 fmol/cell (normally higher in newborns and infants)

Procedure ⬆ ⬇

The MCH is a calculated value. The average weight of Hb in the RBC is expressed as picograms of Hb per RBC. The formula is:

Clinical Implications ⬆ ⬇

  1. An increase of the MCH is associated with macrocytic anemia and in newborns.

  2. A decrease of the MCH is associated with microcytic anemia.

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. Hyperlipidemia falsely elevates the MCH.

  2. WBC count greater than 50,000/mm3 falsely raises the Hb value and therefore falsely elevates the MCH.

  3. High heparin concentrations falsely elevate the MCH.

  4. Cold agglutinins falsely elevate the MCH.