During a routine examination, a 55-year-old female has elevated hemoglobin and hematocrit levels. What should be the next step in her evaluation?

The next step in the evaluation of a patient with elevated hemoglobin and hematocrit levels is to conduct further investigation into the cause of the elevation. This approach is essential because elevated levels can indicate various underlying conditions, such as polycythemia vera, chronic hypoxia, or dehydration, and each of these conditions requires a different management strategy.

Investigating the cause will typically include a detailed patient history, physical examination, and specialized laboratory tests, such as erythropoietin levels or even a bone marrow biopsy, depending on the clinical context. Understanding the source of the elevation is crucial for determining the appropriate treatment and management plan, as simply treating the symptom without addressing the underlying issue could lead to complications.

Immediate blood transfusions and referrals to a hematologist might become necessary later, depending on the findings from the investigation, but they are not the first step in this evaluation. Reinforcing hydration practices might be relevant if dehydration is suspected to be the cause of the elevated levels; however, assuming that without further information would be premature. Hence, prioritizing further investigations aligns with a thorough and careful diagnostic approach in clinical practice.