A nurse is reviewing hematology laboratory results of a client receiving intravenous chemotherapy for leukemia. Which of the following laboratory findings prompts the nurse to initiate neutropenic precautions?
A.
A white blood cell count of 1000/mm3
B.
A red blood cell count of 5 million/mm3
C.
A clotting time of 10 minutes
D.
A thrombocyte count of 90,000 cells/mm3
The correct answer and Explanation is :
The correct answer is A. A white blood cell count of 1000/mm³.
Explanation:
In clients receiving chemotherapy for leukemia, neutropenic precautions are necessary when the client’s white blood cell (WBC) count, particularly their absolute neutrophil count (ANC), is significantly reduced. Neutropenia, defined as a neutrophil count less than 1500 cells/mm³, poses a serious risk because neutrophils are a type of white blood cell crucial for fighting infections. Severe neutropenia (ANC < 500 cells/mm³) is considered critical, making the client highly susceptible to opportunistic infections.
Option A: A white blood cell count of 1000/mm³ indicates significant neutropenia. While this value reflects the total white blood cell count, the neutrophil count is likely low as well. Given the immunosuppressive effects of chemotherapy, the client is at high risk for infection, and initiating neutropenic precautions is vital to prevent exposure to pathogens. This includes strict hand hygiene, using protective masks, limiting visitor access, and ensuring a sterile environment to reduce infection risks.
Option B: A red blood cell count of 5 million/mm³ is within the normal range for most adults and does not suggest neutropenia or a need for neutropenic precautions.
Option C: A clotting time of 10 minutes refers to blood coagulation but does not reflect the client’s immune status or risk for infection. Clotting time is related to bleeding risk, not infection risk.
Option D: A thrombocyte (platelet) count of 90,000 cells/mm³ is low and indicates thrombocytopenia, which increases the risk of bleeding. However, thrombocytopenia does not specifically require neutropenic precautions.
Thus, a WBC count of 1000/mm³ (Option A) suggests neutropenia, prompting the nurse to initiate infection prevention measures.