The stained RBC examination (RBC morphology) involves examination of RBCs under a microscope. It is usually performed to compare the actual appearance of the cells with the calculated values for RBC indices. Cells are examined for abnormalities in color, size, shape, and contents. The test is performed by spreading a drop of fresh anticoagulated blood on a glass slide. The addition of stain to the specimen is used to enhance RBC characteristics.
As with RBC indices, RBC color is described as normochromic, hypochromic, or hyperchromic, indicating, respectively, normal, reduced, or elevated amounts of Hgb. Cell size may be described as normocytic, microcytic, or macrocytic, depending on whether cell size is normal, small, or abnormally large, respectively. Cell shape is described using terms such as poikilocyte, anisocyte, leptocyte, and spherocyte (Table 1-7). The cells are examined also for inclusions or abnormal cell contents, for example, Heinz bodies, Howell-Jolly bodies, Cabot's rings, and siderotic granules (Table 1-8).
Nursing Care Before the Procedure
Client preparation is the same as that for any study involving the collection of a peripheral blood sample (see Appendix I).
A venipuncture is performed and the sample collected in a lavender-topped tube. A capillary sample may be obtained in infants and children as well as in adults for whom venipuncture may not be feasible.
Nursing Care After the Procedure
Care and assessment after the procedure are the same as for any study involving the collection of a peripheral blood sample (see Appendix I).