While the hemogram of a patient taking hydroxyurea (Droxia) for sickle cell disease is being monitored, which laboratory result would prompt an urgent call to the patient's hematologist?
a. Hemoglobin, 5.8 gm/dL
b. Platelet count, 95,000/mm3
c. Reticulocytes, 70,000/mm3
d. Neutrophil count, 2600/mm3
ANS: C
The greatest concern for a patient with sickle cell disease is myelosuppression, which can reduce neutrophil, platelet, and reticulocyte counts. A reticulocyte count of 70,000/mm3 would cause the greatest concern and warrant a prompt call to the prescriber.
A hemoglobin count of 5.3 gm/dL or greater is considered acceptable.
A platelet count of 95,000/mm3 or greater is considered acceptable.
A neutrophil count of 2500 cells/mm3 or greater is considered acceptable.
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