Editing Anatomy and Physiology – RN Practice Questions (section)

==Question 9==
A patient receiving chemotherapy has an absolute neutrophil count of 400 per cubic millimeter and a temperature of 100.6 degrees Fahrenheit (38.1 degrees Celsius). The wound from a recent central line insertion looks clean with no redness or drainage. What is the nurse's priority interpretation?
# The absence of redness and drainage indicates there is no infection.
# The low-grade temperature is an expected side effect of chemotherapy and can be monitored.
# The patient may have a serious infection despite minimal local findings, and the provider must be notified urgently.
# The neutrophil count should be rechecked before any action is taken.

'''Answer:''' 3 (C). The patient may have a serious infection despite minimal local findings, and the provider must be notified urgently.

''Rationale:'' The classic local signs of infection, including redness, warmth, swelling, and purulent drainage, are produced by neutrophils migrating into tissue. A severely neutropenic patient cannot generate that response, so a normal-appearing site does not exclude infection and even a modest temperature elevation may be the only sign of overwhelming sepsis. Neutropenic fever is a medical emergency requiring prompt cultures and empiric antibiotics. Options 1 and 2 misinterpret the absence of inflammatory signs as reassurance. Option 4 delays treatment; the count is already known to be critically low.