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1. Lesson plan on Hb estimation
Subject : Community health Nursing
Topic :Hb estimation
Group : antenatal mothers/ adolescent girls
Place : Family
Date & time : 12.01.2021, 10AM
Duration : 30 minutes
Teaching method : Lecture cum demonstration
AV aids / instructional aids : Sahli’s hemoglobinometer
Student Pre requisite : The students should be able to identify the person whom Hb estimation is necessary and would be able to
recognize the importance of Hb estimation.
General Objective : At the end of the demonstration students will be able to gain knowledge regarding Hb estimation and will
develop necessary attitude & demonstrate skill in hospital and community setting.
Specific Objectives : At the end of the class the students will be able to
 Explain normal Hb level.
 Explain principles of Hb estimation.
 Identify the articles required for Hb testing.
 Describe the steps involved in performing the test.
 Read and interpret the results.

2. Introduction: Estimation of blood hemoglobin is an essential part of pre-operative and other medical screening. The hemoglobin present
inside RBC. It is also called as oxygen carrying pigment. It carries oxygen from lungs to tissue & transport waste product from tissue to lungs
for excretion. So for proper functioning of the body, Hb level always should be in normal level.
Sl.
No
Time Specific
objective
Content Teaching
learning
activity
Evaluation
1 2mins To explain
about
hemoglobin
Hemoglobin
It is a protein of molecular weight 64,000. The molecule is made up of
four subunits, each containing a hem protein attached to a globin chain.
Iron is present in hem protein, so it binds with oxygen loosely &
reversibly. When hemoglobin is combined with oxygen, it is called
oxyhemoglobin and it is bright red in color
T: explains.
S: Listens and
takes notes.
Q: List
indication of
Hb testing?
2 1mins To explain
principles of
Hb
estimation.
Principle: The blood is diluted in an acid solution, converting Hb to acid
hematin. The test solution is matched against colored glass reference.
T: explains
about
principles of
Hb testing.
S: Listens and
understands.
Q: Explain
principles of
Hb testing?
3 5
mins
To Identify
the
instruments
that are used
to measure
Hb level
Articles required
Article Purpose
 Cotton ball, surgical spirit To clean the finger
 Sterile lancet To prick the finger
 Micropipette To take blood sample
 Sahil’s hemoglobinometer For checking Hb
 N/10 HCl acid To make the Hb acidic
 Distilled water Dilute the solution for
matching with color glass reference.
 Absorbent paper
T:
Demonstrates
the procedure.
S: Observe
and recognizes
the article
required for
Hb estimation
Q.
List articles
required for
Hb testing?

3.  Glass rod For steering of solution
6 12min Demonstrate
procedures of
Hb estimation
Procedure
Before procedure:
 Explain the procedure to the client
 Keep all articles ready.
During procedure:
 Fill the calibrated tube to the 20 mark with .1ml/L HCl.
 Clean the finger tip with surgical spirit, allow for drying then prick
with a sterile lancet.
 Wipe away first few drops of blood.
 Suck blood into micropipette up to 20cumm, avoid air bubbles
coming into tubes.
 Wipe the outside tip of pipette with tissue.
 Blow the blood from the pipette into calibrated tube containing
the acid solution.
 Rinse the pipette by drawing in & blowing out the acid solution 3
times.
 Place the hemoglobinometer tube in the stand & allow for 10min
(during this period HCl causes lysis of RBC and release Hb which
gives dark brown colored acid hematin).
 Now using a plasteur pipette to add few drops of distilled water
and stir the content with glass rod.
 Compare the color of calibrated tube with the reference tubes-If
darker continue to dilute the blood acid mixture with distilled
T:
Demonstrates
the procedure.
S: Observe and
understands.
Return-
demonstrate
the
procedures.

4. water drop by drop, all the while stirring with the glass rod.
 Stop when the color match.
 Note the mark that is reached.
After care
Patient: Press the pricked area with spirit cotton.
-Inform the Hb level to client.
-Give health education or treatment according to Hb%.
Article: Rinse the pipette thoroughly to prevent clotting.
-Clean all article & replace it.
-Discard the waste in appropriate bins
7 5min To describe
interpretation
of result
Results
Depending on the type of tube, the result can be read as g/dl or g%.
Interpretation
The normal haemoglobin values for males & female are as follows-
Male: 14-15gm/dl, Female: 13-14gm/dl
Hb% ≤8 : severe anemia
Hb% 8-10: Moderate anemia
Hb% 10-12: Mild anemia
Hb% ≥ 12: Normal
A value much higher than the above will indicate polycythemia.
T: Explains
interpretation
of result.
S: Listen and
takes note.
What is normal
Hb level for
male?
8 5min To describe
advantage &
disadvantages
of Hb testing
Advantages:
 A very simple method.
 Easy to perform with minimum technical expertise
 Apparatus can be transported easily
Disadvantages:
 Color comparison may vary from observer to observer.
 Obstruction of micropipette by air bubble.
 Addition of extra distilled water to tube. Due to tight sucking, extra
T: Discuss.
S: Listen and
takes note.
What are the
disadvantages
of Hb
estimation by
Shali’s
method?

5. VANCOUVER STYLE
cellular fluid may enter the micro pipette.
 Incomplete transformation of hem to acid hematin.
Summary:
 Hb is the oxygen carrying pigment & transport waste product.
 Normal Hb is 14-15g/dl is for male & 13-14g/dl is for female.
 Blood is diluted in acid solution, converting Hb to acid hematin. Then the test solution is matched against colored glass reference.
Evaluation : By return demonstration of Hb estimation.
Bibliography:
1. Kamalam S. Essentials in community health Nursing Practice. Hb estimation.(2012) 2nd edition. Jaypee Brothers medical Publisher (P)
Ltd.