Medical Surgical Labs WBC White Blood Count #2

Question

The nurse is caring for a client receiving radiation and chemotherapy for leukemia. The client’s white blood cell count is 4200 cells/mcL. Which precautions should be followed? Select all that apply.

Answers

  1. Protective isolation precautions
    • Rationale:

      This answer is correct because the client is at risk for infection due to the low white blood cell count. Protective isolation is used for immunosuppressed clients with cancer for prevention of infection. It involves placing the client in a single room, using clean gowns, gloves, and masks for people entering the room, as well as control of air quality.

  2. Food safety precautions
    • Rationale:

      This answer is correct because high risk food sources can cause infection. The client who is leukopenic will be unable to fight infection. This includes infection obtained by eating foods that may contain infection causing germs. Fresh fruits and vegetables have the potential to be tainted with bacteria so are generally avoided in the cancer client with leukopenia.

  3. Droplet precautions
    • Rationale:

      This answer is not correct because droplet precautions are required to prevent the spread of germs from the client to others. A client with a low white blood cell count needs to be protected from others’ droplets, not vice versa. There is no indication in the question that the client has a respiratory infection.

  4. Neutropenic precautions
    • Rationale:

      This answer is correct because the client with a low white count will have low neutrophils, which are a type of white blood cell that arrives first on the scene to fight an infection. They make up 40-60% of white blood cells. Neutropenic precautions include monitoring the client closely for a low-grade fever, placing the client in a room alone, avoiding fresh fruits, veggies, flowers, people who appear sick, crowds, and not drinking water that has been out longer than an hour or from a pitcher.

  5. Radiation precautions
    • Rationale:

      This answer is correct because the client is undergoing radiation. Radiation precautions are used for the protection of healthcare workers and staff caring for a client undergoing radiation. Precautions include protective drapes over equipment, eye protection for caregivers, disposable client drapes to prevent scatter radiation, lead aprons for caregivers, no visitors under the age of 18, and no pregnant visitors. Each hospital will have their own protocol for radiation precautions.

Overview

A client with a white blood cell count under 5000 cells/mcL is leukopenic and at risk for infection. Neutropenic precautions should be instituted, as well as placing the client in protective isolation, food safety precautions, and radiation precautions for anyone entering the room since the client is receiving radiation treatment.

Explanation

Learning Outcomes

A client is leukopenic if their white blood cell count is under 5000 cells/mcL. This puts the client at risk for infection. A client who is leukopenic is unable to fight off infection appropriately. Therefore, neutropenic precautions should be put in place to protect the client. The client should also be placed in isolation away from other clients who may spread germs to the leukopenic client. The client is also undergoing radiation. For this reason, radiation precautions should be followed to protect staff members and visitors.

Test Taking Tip

Read the question carefully and consider all the facts of the question. Then, treat each answer as true or false.

Video Rationale