Neutropenic Precautions: NCLEX Priorities
ANC threshold, private room, no fresh flowers, neutropenic fever protocol.
Neutropenic patients are vulnerable. NCLEX tests precautions and fever response.
Define neutropenia
ANC <500 severe. <100 profound. Common with chemo, immunosuppression.
Precautions
Private room (positive-pressure if available). Hand hygiene strict. No fresh flowers, no raw fruits/vegetables (unless washed and peeled), no uncooked meats. Cooked food only. Avoid crowds. Visitors screened for illness. No live vaccines.
Neutropenic fever
T ≥38.3°C single or ≥38°C sustained. Emergency. Blood cultures × 2, urinalysis, CXR, broad-spectrum antibiotics within 1 hour (cefepime, piperacillin-tazobactam, or meropenem ± vancomycin).
G-CSF
Filgrastim, pegfilgrastim. Reduces duration of neutropenia.
Frequently asked
Why no fresh flowers?
Pseudomonas, Aspergillus, other organisms in soil/water. Risk to neutropenic patient.
When can neutropenic patient eat fresh fruit?
If thoroughly washed and peeled. Safer to cook or skip during severe neutropenia.
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