Hey fellow nurses! I am not in onc--I'm in OB--but I have a quick question for you that are. When someone has been getting chemo for a while and having neutropenic episodes, what happens to their WBC count when they are exposed to a virus or "bug". When it is really low to begin with, do you see a rise? Or, is there really no difference as their immune system is just not able to function? Thanks for the input.
Jan 26, '07
their wbc will not rise because they are immunosuppressed. that's why it is important to watch for non-classic signs of infection in caring for a neutropenic patient. some of them will not even develop fever, will not have localized signs of infection such as pus formation/redness on site of infection. they can become septic quite easily when their counts are low. very interesting question you posted.
Martin S. Marino, RN OCN CMSRN
Jan 26, '07
Another thing to watch is if their counts are trending downward or upward(even upward, it will still be really low). Obviously, if it's trending downward you need to be more cautious than if it has remained steady.
Jan 27, '07
Thanks for the replies! I have a friend with a child going through this and I am so concerned that they just aren't taking the neutropenia seriously enough. The mom just doesn't get the physiology and the docs aren't much help--Ok'd hamsters for Christmas! Am I just being paranoid or would you keep someone home with counts that are too low to get chemo?
Jan 28, '07
pts on neutropenia should be extra careful because as we all know they can easily catch "germs" that is why there is what they call the Neutropenic precaution - in my floor, we are really strict as possible because our patients WBC goes down as low as <0.1 (the lower the better for our patients) this is because we give high dose chemo. We intentionally wipe off the WBC of the patients so that they will have a lesser chance of GVH (graft versus host disease) and this is for patients who receive bone marrow/stem cell/cord blood transplants. Our policy is strict handwashing, patients wear mask when they needed to go out of the room, visitors are limited, no kissing, hugging, do not be too near the patients face, the equipments in patient's room like phone are strictly cannot be used by anybody else that includes bathroom use is for pt only, no fresh food, fresh flowers allowed,etc.
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