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Blood Cancers and NeutropeniaMedical Surgical Nursing

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Term used to denote a decrease in all components of a WBC, including granulocytes, monocytes and lymphocytes...
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Leukopenia
Term to denote a deficiency in neutrophils, eosinophils, neutrophils, and basophils...
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Granulocytopenia
Which components of white blood cells counts are closely monitored as a good indicator of a patient's risk for infection?
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Neutrophilic granulocytes
__________ is the term for a reduction in neutrophils.
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Neutropenia
What is considered severe neutropenia?
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A count less than 500 per microliter
What is the normal range for neutrophils per microliter?
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4000-11,000
What are the three components for determining the clinical significance of neutropenia?
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-the rapidity of the decline, - the degree of neutropenia -the duration
What factors, coupled with neutropenia, caused an increased risk of a serious infection?
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Being older than 60, having an existing infection, having diabetes, being in the hospital
What is the most common cause of a neutropenia?
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Iatrogenic effects from medications used to treat other conditions like cancer or autoimmune conditions
What causes the clinical manifestations of infection to be missed in patients with neutropenia?
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Typically, the normal s/s aren't present due to a reduced phagocytic response. So, the normal redness, swelling, warmth, fever, pus formation, etc. is absent.
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What are the signs and symptoms that require an immediate response if a patient has neutropenia?
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Any fever, sore throat, dysphagia, ulcerative lesions on the cheeks or throat, diarrhea, rectal tenderness or rectal/vaginal itching, vaginal discharge, SOA or a non-productive cough.
What organisms are commonly responsible for systemic infections in patients with neutropenia?
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They are usually normal flora like Staphylococcus aureus, candida or aspergillus. Reactivation of herpes zoster or herpes simplex are also common.
What are the primary diagnostic studies for neutropenia?
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WBC and a bone marrow aspiration/biopsy
What are the major nursing responsibilities related to neutropenia?
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Strict handwashing, visitor restriction, private room, monitor for s/s of an infection (temp 100.4 and up), collection of cultures if warranted, administration of antibiotics.
A patient with neutropenia has a developed a fever and you have taken serial blood cultures and sputum samples. The lab says it will take about 2 hours to process the gram stains to guide therapies. What is your priority at this point?
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Administer antibiotics. They have to be given within an hour of the onset of fever. Broad spectrum antibiotics via IV are usually ordered.
Cephalosporins are common medications given to patients with neutropenia that have developed a fever. What are the common side effects of this type of drug?
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Rashes, fever, pruritis
Aminoglycosides are commonly prescribed to patients who have neutropenia that have developed a fever. What are two common side effects that a nurse should monitor for?
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Ototoxicity and nephrotoxicity
What type of organism is typically the cause of an infection in a patient with neutropenia of a long duration?
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Fungal, the longer the neutropenia, the greater the risk of a fungal infection
Neupogen/filgrastim and Neulasta/pegfilgrastim are G-CSF medications that are commonly given to patients with neutropenia to stimulate the production and function of _________.
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Neutrophils
Leukine or Prokine (sargramostim)are GM-CSF medications that are given to patients with neutropenia to stimulate the production of _________.
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Monocytes and Neutrophils
  
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