The nurse reviews the following laboratory results. What is the priority intervention for client care?
Explanation & Rationale
Choice A reason: While antibiotics are used to treat infections, the current laboratory data shows a WBC count of 0.9 (900/mm3), indicating severe leukopenia/neutropenia. The priority is not to treat a presumed infection without clinical evidence of fever or localized symptoms, but rather to protect the immunocompromised patient from acquiring opportunistic pathogens from the environment or staff. Choice B reason: Obtaining a urine sample is a diagnostic step for a suspected urinary tract infection. However, in the presence of profound neutropenia (WBC < 1000), the patient is at extreme risk for life-threatening sepsis from any microbial exposure. The immediate nursing priority is safety and prevention of exposure through environmental controls before pursuing diagnostic testing. Choice C reason: Fresh-frozen plasma (FFP) is administered to replace clotting factors in patients with coagulopathy or active bleeding. The patient's platelet count is 135,000/mm3, which is within the low-normal range, and there is no indication of impaired coagulation in the provided data. Therefore, FFP administration is not clinically indicated or a priority. Choice D reason: A WBC count of 0.9 (900/mm3) is critically low (normal 5.0-10.0 x 1000). This severe neutropenia necessitates the immediate implementation of protective (reverse) isolation precautions. This includes a private room, strict hand hygiene, and prohibiting live plants or fresh fruits to minimize the risk of healthcare-associated infections in a highly vulnerable patient.