What are the clinical concerns for a 55-year-old, postmenopausal, Caucasian nonsmoker with a hematocrit of 52% and hemoglobin of 17 g/dL? What further evaluation should I offer?—MARY FRAZEE, RN, WHNP, Phoenix

Abnormally high hematocrits are of concern because of the increase in blood viscosity and the concomitant increase in platelets. Technically, however, a hematocrit of 52% is still considered to be the upper limit of normal in this patient and usually does not need further evaluation. Increased hematocrits can also be the normal result of living at higher elevations. In the absence of any symptoms such as ruddy complexion, this patient should be monitored routinely.—Sherril Sego, FNP-C, DNP (146-12)

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