A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a "shift to the left" in a client's white blood cell count. Which action should the nurse take?

Question

a. Request that the laboratory perform a differential analysis on the white blood cells.
b. Notify the provider and start an intravenous line for parenteral antibiotics.
c. Collaborate with the unlicensed assistive personnel (UAP) to strain the client's urine for renal calculi.
d. Assess the client for a potential allergic reaction and anaphylactic shock.

Answer 1

ANS: B
An increase in band cells creates a "shift to the left." A left shift most commonly occurs with urosepsis and is seen rarely with uncomplicated urinary tract infections. The nurse will be administering antibiotics, most likely via IV, so he or she should notify the provider and prepare to give the antibiotics. The shift to the left is part of a differential white blood cell count. The nurse would not need to strain urine for stones. Allergic reactions are associated with elevated eosinophil cells, not band cells.