Deciphering clues in the CBC count
Julie Miller BSN, RN, CCRN
Brandi Starks BSN, RN, CCRN

July 2010 
Volume 40  Number 7
Pages 52 - 55
  PDF Version Available!

AS NURSES, WE REVIEW our patient's lab values daily. The complete blood cell (CBC) count is one of the most frequently ordered screening tests, as well as a tool to evaluate anemia. Anemia is a condition in which there's a reduction in the number of circulating erythrocytes, the amount of hemoglobin, or the volume of packed cells (hematocrit).This article reviews the components of the CBC count, which includes a red blood cell (RBC) count, hematocrit, hemoglobin, RBC indexes, white blood cell (WBC) count, differential WBC count, and platelet count. Understanding these values will help you pinpoint reasons for acute changes in your adult patient's clinical status.Throughout this article, normal lab value ranges are referenced as a guideline, but you'll need to check your own lab reference range. Besides looking at your patient's current lab results, be sure to look for trends during the patient's entire hospital course.Tests of RBCs include the RBC or erythrocyte count, hemoglobin, hematocrit, and RBC indexes.The RBC or erythrocyte count determines the total number of erythrocytes in a cubic millimeter of blood. This measurement is important in the evaluation of anemia or polycythemia (an abnormal increase in the number of RBCs). The normal RBC count is 4.2 to 5.4 106/mm3 in men and 3.6 to 5.0 106/mm3 in women. Causes of decreased RBC count values include anemias, Hodgkin disease, and other lymphomas. Causes of an increased RBC count (also known as erythrocytosis) include polycythemia vera, renal disease, and pulmonary disease.The hematocrit value is determined by spinning blood in a centrifuge, which causes blood cells and plasma to separate.1 This test indirectly measures the RBC mass. Results are expressed as the percentage by volume of packed RBCs in whole blood. It's important, along with hemoglobin and RBC, to determine anemia or polycythemia.2 The normal reference range is 36% to 48% in women and 42% to 52% in men. The

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