A cancer patient undergoing chemotherapy develops a fever of 38.4 C. The latest complete blood count reveals an Absolute Neutrophil Count of 400 cells per microliter. What is the priority nursing intervention?

Appeared in: NORCET-11 Prelims

Explanation

Fever with ANC less than 500 is febrile neutropenia, a medical emergency.
Immediate notification of the physician is required for prompt initiation of cultures and broad-spectrum antibiotics.
Delays in treatment increase risk of sepsis and death.
Classic infection signs may be absent; fever may be the only clue.
Guidelines recommend antibiotics within 1 hour of fever detection in neutropenic patients.

Option A: Antipyretics and rest do not address the risk of rapid infection progression in neutropenic patients.
Option B: Delaying intervention by reassessing later can lead to rapid deterioration in febrile neutropenia.
Option C: Neutropenic precautions are important but do not replace the need for immediate escalation and antibiotic therapy.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing intervention for febrile neutropenia in cancer patients in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Nurses must act quickly in febrile neutropenia to prevent sepsis and death.
Early notification and intervention are critical for patient safety.
What if? If ANC was above 1000, supportive care and monitoring might be appropriate before escalation.

How to Approach the Question

Identify the clinical scenario: cancer, chemotherapy, fever, and low ANC.
Recall that ANC less than 500 with fever is a medical emergency.
Eliminate options that delay action or only provide supportive care.
Choose the option that enables immediate escalation and life-saving intervention.
Remember: In febrile neutropenia, time to antibiotics is critical.

Concept Tested & Keywords

Concept Tested: Priority nursing intervention for febrile neutropenia in cancer patients
Stem keywords: cancer patient, chemotherapy, fever 38.4 C, Absolute Neutrophil Count 400
Lead-in keywords: priority nursing intervention
Clinical cues: immunocompromised state
Clinical cues: fever as only sign of infection

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 pp. 37-39, 38-40

E6 Medicine Harrison 22e Part 1 p. 621-623

Practise the full NORCET-11 Prelims

Attempt every question from this paper in a timed mock, then review the full solution for each one.