Which condition would the nurse monitor for in a patient who has a hemoglobin level of 20g dL?

Decreased hemoglobin:

Blood loss and bone marrow suppression reduce total RBC count and therefore lower total hemoglobin content. Hemoglobin levels are also lowered in patients who have abnormal types of hemoglobin or hemoglobinopathies. Red blood cells with abnormal types of hemoglobin are often fragile and damaged or destroyed easily in the vascular system. Hemoglobin electrophoresis can distinguish among specific types of abnormal hemoglobin.

Thalassemia is an inherited recessive hemoglobinopathy. It results from a failure to produce sufficient globin molecules. The failure can be in either the alpha or beta portion. In sickle cell anemia, the patient has an abnormally shaped hemoglobin known as sickle hemoglobin (hgbS). Sickle hemoglobin creates misshapen RBCs which form blockages in the vessels.

Other patients have a normal RBC count but a low hemoglobin level. This situation occurs with iron-deficiency anemia, in which red blood cells have less hemoglobin than normal. Iron deficiency anemia is also referred to as hypochromic anemia. Hypochromic is a term that means "less than normal color." In general, women need more iron in their diets than men, due to the regular loss of iron in the menstrual flow. During pregnancy a woman's need for iron to build more hemoglobin increases. If a woman becomes pregnant when she has low iron reserves, she is at risk of becoming severely anemic. Regular hemoglobin testing is an important part of prenatal care. During the last trimester of pregnancy, a condition known as "physiological anemia of pregnancy" occurs. This normal drop in hemoglobin values results from an increase in the plasma volume. Multiple blood draws in premature infants is a common cause of anemia.

Instant Feedback:

Red blood cells that have abnormal hemoglobin are damaged or destroyed more easily than cells with normal hemoglobin.

Hemoglobin: critical low and high values

• A hemoglobin value under 5 g/dl may cause heart failure
• A hemoglobin value over 20 g/dl may cause clogging of capillaries due to hemoconcentration

Increased levels of hemoglobin are found in any condition in which the number of circulating red blood cells rises above normal. Examples of conditions associated with increases in hemoglobin are polycythemia vera , severe burns, chronic obstructive pulmonary disease, and congestive heart failure.

For more information about anemia, consider visiting the AMERICAN SOCIETY of HEMATOLOGY

http://www.hematology.org/Patients/Other-Resources/Education-Book/5302.aspx

© RnCeus.com

High hemoglobin (Hgb) count occurs when your red blood cells have an unusually high amount of the blood protein hemoglobin. Hemoglobin gives red blood cells their red color. It helps carry oxygen from your lungs to the rest of your body and carries carbon dioxide (CO2) from the rest of your body back to your lungs. Another name for high hemoglobin is polycythemia.

What is the difference between high hemoglobin and hematocrit?

Hematocrit is the volume of red blood cells compared to other blood cells. People with high hemoglobin often also have high hematocrit, meaning they have irregularly high red blood cell counts.

What are high hemoglobin levels?

Both your biological sex and age affect your hemoglobin levels. Typically, hemoglobin levels are considered high if they’re:

• Above 16.5 grams per deciliter (g/dL) in an adult who was assigned male at birth.
• Above 16 g/dL in an adult who was assigned female at birth.
• Above 16.6 g/dL in a child.
• Above 18 g/dL in an infant.

Environmental factors such as altitude, time of day and how hydrated you are also can affect your hemoglobin levels.

How do I know if I have high hemoglobin?

A blood test is the only way to know if you have high hemoglobin. Some of the side effects of high hemoglobin may include:

Is high hemoglobin serious?

You should take high hemoglobin levels seriously. Sometimes, high hemoglobin points to a serious underlying condition. Even if you don’t have an underlying condition, it’s important to treat a high hemoglobin count. Irregularly high hemoglobin levels can lead to complications such as blood clots.

Treatment for high hemoglobin count varies depending on the underlying cause. In some cases, your healthcare provider may recommend a phlebotomy. In a phlebotomy, a healthcare provider inserts a needle into one of your veins and removes extra red blood cells. You may need to have multiple phlebotomies until your hemoglobin levels are within a typical range.

What should I do if my hemoglobin is high?

See your healthcare provider if you have high hemoglobin or think you may. They can use a hemoglobin blood test to check your hemoglobin levels and offer treatment options.

How can I prevent high hemoglobin count?

You can’t always prevent high hemoglobin. But you can lower your risk of developing high hemoglobin with a few lifestyle changes:

• Avoid using performance-enhancing drugs.
• Eat a nutritious diet with plenty of fruits and vegetables.
• Stay hydrated by drinking plenty of water and other liquids.
• Quit smoking.

Your doctor should always treat high hemoglobin count. Call your healthcare provider if you experience new symptoms of high hemoglobin. If you know you have high hemoglobin, call your healthcare provider if you experience worsening symptoms.

A note from Cleveland Clinic

High hemoglobin count occurs when you have unusually high levels of a specific blood protein. The blood protein hemoglobin helps carry oxygen throughout your body and takes carbon dioxide to your lungs. High hemoglobin levels can lead to dizziness, fatigue, easy bruising and other symptoms. Depending on the underlying cause of high hemoglobin, your healthcare provider may recommend treatment to remove excess red blood cells from your blood.

Last reviewed by a Cleveland Clinic medical professional on 06/20/2022.

References

• Billett HH. Hemoglobin and Hematocrit. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Accessed 6/20/2022.
• National Institutes of Health, National Library of Medicine. Hemoglobin Test. (https://medlineplus.gov/lab-tests/hemoglobin-test/) Accessed 6/20/2022.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy