Neutropenia – Flashcards
Unlock all answers in this set
Unlock answersquestion
Neutropenia
answer
defined as an absolute neutrophil count of less than 1000 cells/microliter of blood. Low granulocytes. Could be caused by inadequate production or excess destruction
question
Absolute neutrophil count
answer
determined by multiply the total WBC count by the percentage of neutrophils.
question
Normal neutrophil count
answer
2200 to 7700 cells/uL
question
Severe neutropenia
answer
less than 500 cells/uL
question
In clinical significance of neutropenia it is important to know
answer
whether the decree in neutrophil count was gradual or rapid, the degree of neutropenia, and the duration.
question
Causes of neutropenia
answer
cancer treatment, antimicrobial agents, anti-inflammatory drugs, cardiovascular drugs, diuretics, psychotropic agents, aplastic anemia, leukemia, myelodysplastic syndrome, SLE, Felty syndrome, rheumatoid arthritis, viral, infection, sepsis, nutritional deficiencies
question
nadir
answer
lowest point of neutropenia and other blood cells in a patient treated with chemotherapy
question
Hemoglobin levels
answer
males: 13.2-17.3 and females: 11.7-16
question
Platelet levels
answer
150,000 - 400,000
question
Chemotherapy manifestations
answer
alopecia, decreased skin integrity, increased risk of destruction of normal GI flora, bone marrow issues and destroy neutrophils and WBC
question
Chemotherapy goal
answer
eliminate number of malignant cancer cells and decrease primary tumor size and decrease risk for metastasis.
question
Mild neutropenia
answer
ANC 1,000 - 1,500
question
Moderate neutropenia
answer
ANC 500-1,000
question
Monitor neutropenic patient for
answer
signs and symptoms of infection. Fever greater than 100.4 F, and early septic shock.
question
If a patient with neutropenia has a fever
answer
they are considered an emergency.
question
Early identification of a potentially infective organism depends on
answer
acquiring cultures from various sites. Serial blood cultures, at least two, or one from a peripheral site and one from a venous access device should be done promptly and antibiotics started immediately, within 1 hour.
question
What other cultures can be ordered in the surveillance of a neutropenic patient with possible infection?
answer
sputum, throat, lesions, wounds, urine, and feces. Also may be necessary to do a tracheal aspiration, bronchoscopy with bronchial brushings, or lung biopsy to diagnosis the cause of pneumonic infiltrates.
question
When a febrile episode occurs in a neutropenic patient...
answer
antibiotic therapy must be initiated immediately , within 1 hour, even before the determination of a specific causative organism by culture.
question
The longer the neutropenia, the greater the risk of a ______ infection.
answer
fungal
question
_____ is the single most important preventive measure to minimize the risk of infection in the neutropenic patient.
answer
hand washing
question
What type of room should a neutropenic patient be placed into?
answer
reverse isolation
question
Immunocompromised patients
answer
Symptoms of infection may be absent or masked or present atypically. Fever is considered the cardinal and sometimes only symptom of infection. Some patients may not have a fever. Patients are more likely to complain of pain at site of infection. Inflammation may be absent.
question
nursing diagnosis of neutropenia
answer
risk for infection, risk for opportunistic infections
question
nursing goals
answer
1st determine cause of neutropenia, determine organism through cultures, prevent infection, keep chemo from infection, WBC count and neutrophils stay within normal limits, make sure no HAIS or opportunistic infection, ensure patient follows health regime
question
Nursing intervention
answer
avoid crowded places, put patient in reverse isolation, obtain cultures, get x-ray, broad antibiotic coverage, then narrow antibiotic, vigilant about oral care, nutritional support, normal skin care up, good am care and perineal care, no fresh flowers.
