One of the adverse effects of a chemotherapy drug being administered to a client is depression of pluripotent stem cells. Which change in this client's lab values would the nurse expect after treatment is initiated?
1. Decrease in red blood cells only
2. Abrupt decrease in hemoglobin and serum ferritin levels
3. Abrupt decrease in red blood cells, white cells, and platelets
4. Gradual decrease in red blood cells with a gradual increase in white blood cells
Correct Answer: 3
Rationale 1: All cells derived from the stem cells would decrease in number.
Rationale 2: Hemoglobin would decrease, but there would be no effect on the level of circulating iron.
Rationale 3: Depression of pluripotent stem cells decreases the blood level of RBCs, WBCs, and platelets.
Rationale 4: Both red and white blood cell levels would decrease rapidly.
Global Rationale: Depression of pluripotent stem cells decreases the blood level of RBCs, WBCs, and platelets. Hemoglobin would decrease, but there would be no effect on the level of circulating iron.
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