HEMOGLOBIN
● Hemoglobin is
the protein component of red blood cells that acts as a carrier for oxygen and
carbon dioxide transport.
● It is composed
of heme (a pigment) that carries iron, and globin (a protein).
● A
hemoglobin test measures the amount of hemoglobin in your blood.
● If hemoglobin
level is lower than normal, it means you have a low red blood cell count
(anemia).
● If a hemoglobin
level is higher than normal, there are several potential causes the blood
disorder polycythemia vera, living at a high altitude, smoking and dehydration.
● When your
hemoglobin level is low, it means your body isn’t getting enough oxygen, making
you feel very tired and weak.
● A severe low
hemoglobin level for men is 13.5 gm/dL or lower.
● For women, a
severe low hemoglobin level is 12 gm/dL.
● Hemoglobin
tests are measured as part of a complete blood count (CBC).
Normal level of Hemoglobin
● Newborn: 14 to
24 g/dL or 140 to 240 g/L
● Infant One (1) week
of age: 15 to 20 gm/dL
● Infant One (1)
month of age: 11 to 15 gm/dL
● Children: 11 to
13 gm/dL
● Adult males: 14
to 18 gm/dL
● Adult women: 12
to 16 gm/dL
● Men after middle
age: 12.4 to 14.9 gm/dL
● Women after middle
age: 11.7 to 13.8 gm/dL
● Critical values:
<5 g/dl or >20g/dl
Indications of Hemoglobin
● To measure
severity of anemia or polycythemia and to monitor response to therapy.
Interpretation of Hemoglobin
● Low hemoglobin indicates
anemia, characterized by an insufficient RBC count to deliver oxygen to peripheral
tissues.
● High hemoglobin indicates
polycythemia when the hemoglobin is more than 18.5g/dl in men and 16.5g/dl in women.
Increased Levels of Hemoglobin
● Polycythemia
vera
● Burns
● Chronic
obstructive pulmonary disease
● Congenital
heart disease
● Congestive
heart disease
● Dehydration.
Decreased Levels of Hemoglobin
● Anemia
● Nutritional
deficiency
● Bleeding from
digestive tract or bladder,
● Heavy menstrual
periods
● Hemolysis
● Hemorrhage
● Lymphoma
● Kidney disease
● Splenomegaly
● Thalassemia
● Liver disease
● Cancer
● Neoplasia
● Low level of
iron, folate, vitamin B12, or vitamin B6
Interfering Factors of Hemoglobin
Conditions that cause changes in plasma volume without
changes in overall RBC cell count can also affect the Hb and may lead to
relative anemia or relative polycythemia.
Nursing Implications of Hemoglobin
● Manage fatigue
● Maintain
adequate nutrition
● Maintain
adequate perfusion and encourage patient compliance with prescribed therapy.
How to increase hemoglobin levels
● Transfusing red
blood cells
● Receiving
erythropoietin (a hormone used to stimulate red blood cell production in
individuals with decreased red blood cell production or increased red cell
destruction)
● Taking iron
supplements
● Increasing the
intake of iron-rich foods, such as: eggs, spinach, artichokes, beans, lean
meats, and seafood.
● Increasing the
intake of foods rich in cofactors, such as: vitamin B6, folic acid, vitamin
B12, and vitamin C.
● Such foods
include fish, vegetables, nuts, cereals, peas, and citrus fruits.
Hemoglobin A1c test
Hemoglobin A1c or glycosylated hemoglobin is a rough
indication of blood sugar control in people with diabetes mellitus over the
preceding 3 months.
As more glucose (blood sugar) circulates in the blood on a
daily basis, is bound to the circulating hemoglobin.
Normal hemoglobin A1c levels range between 4% to 5.9%.
As this number reaches 6% or greater, it signifies poorer
diabetes control.
Hemoglobin A1c of 6% roughly correlates with an average
blood sugar level of 135 mg/dL (milligrams per deciliters) over the previous 3
months.
Each 1% increase in hemoglobin A1c above 6% represents an
average blood sugar of approximately 35 mg/dL over 135 mg/dL
A hemoglobin A1c measurement of 7% corresponds to an average blood sugar level of 170 mg/dL in the previous 3 months.
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