Hemoglobin (Hgb) (Nursing)

00:01 So let's take a look at hemoglobin.

00:03 Now you see that we often shorten that to be Hgb.

00:07 Now, its job is to carry oxygen throughout the body.

00:09 Doesn't it feel great that that's really familiar to you? It's 95% of the dry weight of a red blood cell, so this is the meat of the red blood cell.

00:18 Remember the red blood cell is just that sack that carries the hemoglobin.

00:22 Hemoglobin has a quaternary structure.

00:25 4 globular proteins. There's 4 units that can carry oxygen in an adult patient; 2 alpha and 2 beta.

00:30 Now you don't need to ever memorize it's 2 alpha, 2 beta, but just know that there are 4 globular proteins in an adult hemoglobin.

00:38 So each group has a heme molecule, and it has an iron center that loves to bind with oxygen.

00:45 So each red blood cell has a hemoglobin.

00:48 It can carry 4 oxygen components with it.

00:52 So let's talk about what happens when you have extra cells.

00:56 You've got polycythemia vera, that's a bone marrow is going crazy.

01:00 You could be in a high altitude.

01:02 Remember that's an adaptation to altitude.

01:05 Now we talked about that previously.

01:07 See if you can stop the video for just a minute and jot some quick notes as to why high altitude would give you a higher hemoglobin.

01:19 Okay, hopefully, you remembered that in a high altitude, there's less oxygen available.

01:25 So if you're there long enough, the body will adapt by putting out extra red blood cells.

01:30 Extra red blood cells means a higher hemoglobin.

01:34 Same thing with congenital heart disease.

01:36 We've looked at each one of these previously.

01:39 Anything that causes an elevated red blood cell will also cause the hemoglobin to be elevated.

01:46 Same thing with anemia.

01:48 Anything that causes a lower red blood cell will cause a lower hemoglobin.

01:53 So if you ever see a patient that has a low hemoglobin, you want look for some of these problems that we've discussed in the other slides.

02:01 So, chronic renal failure, because they don't have erythropoietin, which stimulates red blood cells.

02:07 Pernicious or aplastic anemia, damage to your bone marrow, leukemia/lymphoma, where you have acute or chronic blood loss, or you've got some nutritional deficiencies.

02:17 So, looking at this, like you don't have multiple slides to remember.

02:22 We're just walking you through the concept that anything that causes elevated red blood cells will cause elevated hemoglobin.

02:30 Anything that causes decreased red blood cells will cause decreased hemoglobin.