Question

S.T. completes her first course of chemotherapy in the clinic. You are preparing discharge instructions to help her manage self-care until her next appointment in 4 weeks. You know that her WBC, absolute neutrophil count, platelet count, hemoglobin, and hematocrit levels will reach the nadir in 2 weeks.

1. Define nadir.

2.         What does this mean for S.T.?

3.         What will you teach S.T. about self-care during the nadir period?

Answer 1

1. Nadir means pointing downwards to the lowest possible situation or it can refer to the lowest count of a particular cell due to various causes.

2. In this case, nadir means decreasing the count of WBC, absolute neutrophil count, platelet count, hemoglobin, and hematocrit levels to the lowest possible point because of chemotherapy.

S.T completed her chemotherapy; Chemotherapy is a treatment using chemical agents to kill cancer cells in the body. Chemotherapy can also kill normal cells of the body like blood cells or can suppress blood cell production. which is the main cause of S.T's low blood cell count.

3. In the nadir period, S.T should be more careful about her health, she should follow below points

- Due to leukopenia(Low WBC count), she is very prone to get an infection in this period. So, she should practice handwashing, should maintain hygiene during food preparation and eating. she should use a mask while outdoor and keep a distance from the infectious patients.

- Due to low platelet count, she has a greater risk for bleeding, so, she should be care full during any activity to prevent injury and should avoid outdoor games.

- Her RBC and hemoglobin count will decrease which will decrease her oxygen-carrying capacity of blood so, she should avoid heavy exercise and activity.

- She should take a diet rich in protein and carbohydrates to maintain energy levels and her weight.

- Advice her to keep away from smoking and Alchohol.