Question

Mary Saeger, a 56-year-old woman, is receiving outpatient chemotherapy for bladder cancer. A round of chemotherapy consists of gemcitabine on day 1 and day 8. Cisplantin is administered on day 2. A CBC with differential is ordered prior to the chemotherapy on day 1, day 8, and 1 week after the chemotherapy. The absolute neutrophil count (ANC) is 489/mm³ at 1 week after the chemotherapy. The patient’s temperature is 97.6°F.

a. What is the significance of the absolute neutrophil count?

b. Based on the reason for the neutropenia, what medical management would you anticipate?

c. What patient teaching will the nurse provide to the patient?

Answer 1

a.measure of number of neutrophils in blood, neutorophils in bloods are responsible for immunity and helps body to fight ingections,An absolute neutrophil count may be used to check for infection, inflammation, leukemia, and other conditions. The lower a person's absolute neutrophil count is, the higher the risk is of getting an infection.absolute neutrophil count of less than 500 means there is a high risk of getting an infection. Cancer treatment, such as chemotherapy, may reduce the absolute neutrophil count.

b.Neutropenia is managed by chemotherapy dose modification, dose interval delays, and/or initiation of primary prophylaxis with recombinant granulocyte colony– stimulating factors (G-CSFs) in appropriate patients based on individualized febrile neutropenia risk assessment of the patient and of the chemotherapy regimen.

c. to report to hospital incase of fever, beacuse it might require admisison and antibiotic administration, proper nutrition,temperature monitoring.any signs of infection, uti.