A nurse is evaluating a patient who is receiving chemotherapy. The nurse checks the patient's neutrophil count and notes that it is 900 cells/mm3 . What intervention by the nurse would be most appropriate?
a. Skip the next dose of chemotherapy and notify the prescriber.
b. Discontinue chemotherapy, because it is at a dangerous level.
c. Hospitalize the patient, because there is a risk of possible infection.
d. Continue to monitor the neutrophil count carefully, in case it continues to drop.
D
Neutrophil counts must be monitored. Normal counts range from 2500 to 7000 cells/mm3 . If neutropenia is substantial (ie, an absolute neutrophil count below 500/mm3), chemotherapy should be withheld until the neutrophil count returns toward normal.
The next dose should not be skipped unless the neutrophil count is below 500/mm3.
The chemotherapy should not be discontinued, because the low neutrophil level is not considered "substantial" yet.
There is a risk for infection, but hospitalization is not indicated. The patient is safer in the home environment.
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