A client admitted to a medical - surgical unit has a CBC with differential drawn. Lab results show a WBC count of 4000, with neutrophil segments at 5% and neutrophil bands at 5%. Based on these values what would the nurse do? Calculate the absolute neutrophil count
Place the client on bleeding precautions.
Place the client in a private room.
Document findings in the client's chart
Collect blood cultures and start antibiotics.
The Correct Answer is B
A. Bleeding precautions are not required as the issue pertains to neutropenia, not thrombocytopenia.
B. Placing the client in a private room is appropriate as the ANC calculation (WBC × [% neutrophils]) indicates severe neutropenia, increasing the risk of infection.
C. Simply documenting findings does not address the client’s increased infection risk.
D. Blood cultures and antibiotics may be needed later but require additional signs of infection to proceed.
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Related Questions
Correct Answer is C
Explanation
A. Sinus rhythm is the normal rhythm of the heart with regular P waves, QRS complexes, and T waves. The presence of a sinus rhythm would mean the heart is pumping blood effectively, so the client would not be pulseless. This is inconsistent with the clinical scenario.
B. Ventricular tachycardia (VT) is a fast, regular rhythm originating in the ventricles. VT can lead to pulselessness if not treated, but it has distinct QRS complexes that are wide and regular, unlike the chaotic waveform seen in VF.
C. Ventricular Fibrillation appears as rapid, chaotic electrical activity without identifiable P waves, QRS complexes, or T waves. This rhythm prevents the heart from pumping blood, causing the client to be pulseless and unresponsive. VF is the most common arrhythmia associated with sudden cardiac arrest and requires immediate defibrillation.
D. Sinus tachycardia is a fast heart rate (>100 bpm) with regular rhythm, identifiable P waves, and QRS complexes. This rhythm typically occurs in response to stress, fever, or hypovolemia, and the client would have a pulse, which contradicts the scenario.
Correct Answer is B
Explanation
A. Bleeding precautions are not required as the issue pertains to neutropenia, not thrombocytopenia.
B. Placing the client in a private room is appropriate as the ANC calculation (WBC × [% neutrophils]) indicates severe neutropenia, increasing the risk of infection.
C. Simply documenting findings does not address the client’s increased infection risk.
D. Blood cultures and antibiotics may be needed later but require additional signs of infection to proceed.
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