Quick answer to question, pls..

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What is the sign of infection in a neutropenic patient ? Heat, redness, pus or difficulty swallowing.

Thank you :)

Specializes in ER/ICU/STICU.
Dysphasia, or dysphagia? I thought it was throat problems, not impaired speech....:)

Haha. I made the same spelling error.:smackingf

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Specializes in PICU, ICU, Hospice, Mgmt, DON.

and some people just don't know when to quit!

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Leslie...telling someone they are mediocre for asking a question...calling them honey and telling them to get on with their life or get over it isn't all that nice especially when this thread simply asked a question. Even the page you provided said "heat."

I have been gracious and read all opinions respectfully. I appreciate them all.

If you have an instant dislike for me...please ignore my posts.

I will share that I contacted accreditation associations who were interested in what I had to say. I was hoping to be even more researched in future dealings with them by using the vast resource of this forum... Not start a bashing poor tunafish thread :)'

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Diva... Do I quit when you think I should? Many people in history have made changes when divas told them to quit before they broke a nail :)

Thanks for your insight !

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Leslie and all,

I would never have entered anything ill prepared. Hard data was in hand. How would you then extrapolate that difficulty swallowing was the correct-encompassing answer when in both documentation presented heat was mentioned first?

http://www.scma-docs.com/neutro_pg.htm

"What to look for: Fever is the most common, and sometimes, the only hint that there is an infection. Every patient getting chemotherapy or radiation therapy must have his or her own thermometer. Glass is usually better than digital, unless there are vision problems. Rectal thermometers (round bulb) are safer because they are more difficult to break than (long bulb) oral thermometers. Both can be used in the mouth. A documented temperature of 101.0 or above, for more than one hour, in an oncology patient deserves medical attention. At that time, blood work should be done to look for neutropenia. If a low WBC is found, then a search for the source of the infection (chest x-rays, cultures, etc.) will be undertaken and antibiotics should be considered. Treatment may be as an outpatient or as an inpatient, depending on several factors. "

tunafish, what am i looking for here?

in the 1 post above, you refer to "both documentation presented heat was mentioned first?"

where/what documentation?

and in your 2nd post, what is the point of this article? what am i supposed to be understanding?

leslie

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Leslie.. Your wikipedia link and the other link posted by someone else. Both stress to look for heat or temp. change.

I did not ask for vast amounts of your energy to be wasted on this. You answered your opinion, I appreciate it.

Thank you.

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My ANC was extremely low....I ended up with otitis externa that went into cellulitis of my upper neck/jaw.....there was heat, redness, pain, and fever (103). The symptoms weren't as easily identifiable by me (so didn't know to ask one of the nurses to check-- it was the ear 'away' from the door, so not 'out there' and seen by someone who walked in the room) until my outer ear was swollen shut. Later, the ENT suctioned pus out once the swelling went down enough to get a look inside. I was already on vanc and gent when this occurred.

JME

xtx, it still sounds like your infection wasn't detected until it advanced to the cellulitis.

'normally', it would have been detected w/the ear infection.

(don't mind me..i'm rereading this thread again and rather than skimming, i'm actually reading. yay for me?:lol2:)

leslie

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

if a patient is severely neutropenic—they may not show the "typical" signs of infection that we are used to looking for. this is because the body is not producing wbc’s. normally, when we have an infection—the wbc’s increase and this is what causes the redness, pus, and swelling that we are all so familiar with.

the most reliable sign (and many times the only sign) will be a fever > 100.5 f (38 c). find out what temperature your mds consider to be "a fever". they do not all agree on what the "magic number" is. of course, if you do see any traditional signs or symptoms of infection in a patient at risk—they need to be taken very seriously.

respiratory: cough, sob, crackles, rhonchi, wheezes

gu: burning, frequency, dysuria, hematuria, cloudy urine, lady partsl discharge

gi: diarrhea, guiac positive stools

skin & mucous membranes: redness, tenderness, swelling, "fungal" white patches

indwelling devices: iv lines and urinary catheters symptomatic for infection

some folks will "act septic" and never even have positive blood cultures. some common infections can take an unexpected course in neutropenic patients; formation of pus, for example, can be notably absent, as this requires circulating neutrophil granulocytes. some common symptoms of neutropenia include fevers and frequent infection. these infections can result in conditions such as mouth ulcers, diarrhea, a burning sensation when urinating, unusual redness, pain, or swelling around a wound, or a sore throat.

http://emedicine.medscape.com/article/204821-clinical

i hope this helps...;)

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Specializes in Pediatrics.
Yes, you can get s/s of a 'typical' infection w/neutropenia.....

My ANC was extremely low....I ended up with otitis externa that went into cellulitis of my upper neck/jaw.....there was heat, redness, pain, and fever (103). The symptoms weren't as easily identifiable by me (so didn't know to ask one of the nurses to check-- it was the ear 'away' from the door, so not 'out there' and seen by someone who walked in the room) until my outer ear was swollen shut. Later, the ENT suctioned pus out once the swelling went down enough to get a look inside. I was already on vanc and gent when this occurred.

JME

While anything is possible, exam questions are based on what is typically or most commonly expected. Often we try to draw from our own experienced to help us answer questions, we need to be very careful with this.

My favorite example of this argument is the "growth and development" milestones. You know, the baby who is potty trained at 9 months :)

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I think I'd have to see how the question was asked exactly.

And I doubt this one single question is what led to your D in this course or the C in the other course.

Your energy is being spent trying to prove that you were just as mediocre as your fellow classmates that managed to pass. Instead, put your energy into going into your next semester prepared to learn the material well enough that you'll do well enough on your tests that one single question isn't the difference between passing and failing.

Well stated.

And I was wondering if this was the same poster. Looks like there is a lot more here than meets the eye.

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Specializes in PICU, ICU, Hospice, Mgmt, DON.
Well stated.

And I was wondering if this was the same poster. Looks like there is a lot more here than meets the eye.

It was and I guess she just didn't like the original 60 or so responses...look for another, the 3rd time is the charm, you know!;)

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Ummm same poster .... Different question. Is that not allowed?

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