Medical Surgical Labs WBC White Blood Count #5

Question

The nurse is providing care to a client who has recently become leukopenic with a white blood cell count of 2600 cells/mcL. Which interventions may the nurse implement with this change in the client’s status?

Answers

  1. Obtain an order for a central venous line.
    • Rationale:

      This answer is correct because it would limit invasive procedures as much as possible. This would reduce the need for frequent invasive procedures. A break in skin provides entry for bacterial and other potentially lethal organisms.

  2. Discontinue the indwelling urinary catheter.
    • Rationale:

      This answer is correct because having an indwelling urinary catheter places the client at risk for infection. A catheter allows bacteria to enter the body. The presence of a urinary catheter is the main risk for bacteriuria.

  3. Provide daily body hygiene with antimicrobial solutions.
    • Rationale:

      This answer is correct because good hygiene keeps bacteria low. Preventing skin dryness with lotions is also recommended. The skin is the first line of defense against infection, so keeping the skin healthy and hydrated promotes skin integrity.

  4. Provide a diet high in protein, fresh fruits, and vegetables.
    • Rationale:

      This answer is not correct because the client should not eat raw fruits or vegetables. The client should be placed on a low-microbial diet since fresh fruits/vegetables may contain bacteria.

  5. Remove and prohibit flowers and plants from the client's room.
    • Rationale:

      This answer is correct because live flowers and plants contain aspergillus, which is a fungus that can cause an infection in the lungs. A client can be infected with aspergillus by inhaling the mold spores or by a break in the skin. The client with leukopenia may not have enough white blood cells to defend against such an infection.

Overview

Leukopenia is defined as having a white blood cell count under 5000 cells/mcL, which puts the client at risk for infection. In a leukopenic client, an infection is a medical emergency and can become lethal. Interventions for risk of infection must be implemented.

Explanation

Learning Outcomes

Leukopenia is defined as having a white blood cell count under 5000 cells/mcL, which puts the client at risk for infection. In a leukopenic client, an infection is a medical emergency and can become lethal. Interventions for risk of infection must be implemented. A break in the skin provides entry for bacterial and other potentially lethal organisms. For this reason, frequent invasive procedures should be limited. A central venous line would be an appropriate intervention. Also, since the skin is the first line of defense against infection, keeping the skin healthy and hydrated promotes skin integrity. The presence of a urinary catheter places the client with leukopenia at risk for infection and should be removed. Providing daily body hygiene to the client with antimicrobial solutions should be implemented. Placing the client on an antimicrobial diet and removing fresh flowers and plants from the room will also protect against bacteria and fungal infections.

Test Taking Tip

When looking at the answer choices, ask yourself, “Could this cause an infection?” in the client with leukopenia.

Video Rationale