A client admitted to a medical-surgical unit has a CBC with differential drawn. Lab results show a WBC count of 4,000 with neutrophil segments at 5% and neutrophil bands at 5%. Based on these values, what will the nurse do? Calculate the absolute neutrophil count.
Explanation & Rationale
A. Place the client in a private room: The client’s absolute neutrophil count (ANC) is calculated as follows: ANC = WBC × (%segs + %bands)/100 → ANC = 4,000 × (5 + 5)/100 = 4,000 × 0.10 = 400 cells/µL. An ANC of 400 indicates severe neutropenia (<500/µL), placing the client at high risk for infection. Implementing neutropenic precautions, such as placing the client in a private room, is critical to minimize exposure to infectious agents. B. Collect blood cultures and start antibiotics: While severe neutropenia increases the risk of infection, empiric antibiotics are generally initiated only if the client exhibits signs of infection such as fever, hypotension, or other systemic symptoms. Immediate antibiotic administration without evidence of infection is not standard practice, though infection prevention is prioritized. C. Place the client on bleeding precautions: Bleeding precautions are indicated for thrombocytopenia, not neutropenia. While lab monitoring is important for all cell lines, the primary concern here is infection risk due to neutropenia, not bleeding risk. D. Document findings in the client’s chart: Documentation is necessary, but it is not an intervention that protects the client from the immediate high risk of infection. Prompt implementation of infection control measures, including private room placement and strict hand hygiene, is the priority.