In a patient with a completed medical history indicating high hemoglobin levels, what should the NP be cautious about during evaluation?

In evaluating a patient with elevated hemoglobin levels, it is crucial to consider potential dehydration issues. High hemoglobin concentrations can be indicative of hemoconcentration, which often occurs due to a decrease in plasma volume. This could happen as a result of dehydration, where fluid loss surpasses the red blood cell count, leading to relative polycythemia.

When reviewing a patient with high hemoglobin, the healthcare provider should assess their hydration status. Signs of dehydration, such as dry mucous membranes, increased thirst, or decreased urine output, can provide important clues. If dehydration is present, it can lead to complications such as increased blood viscosity, putting the patient at risk for thromboembolic events. Addressing hydration both in assessment and management allows for a more accurate understanding of the patient’s overall health and prevents any misinterpretation of their hemoglobin levels due to fluid imbalance.

In contrast, while sleep disturbances, ongoing gastrointestinal hardships, and risk of infection may be relevant to certain clinical scenarios, they are not directly associated with elevated hemoglobin levels, making hydration assessment the priority in this context.