A patient with leukemia has a WBC count of 3000. Which precaution is used to prevent infection?

AIIMS Rishikesh NO - 2019

Applied Microbiology & Infection control

Medium

Appeared in: AIIMS Rishikesh NO - 2019

Explanation

A White Blood Cell (WBC) count of 3000/mm³ is below the normal range (4,500-11,000/mm³), a condition known as leukopenia.
Patients with leukemia are immunocompromised due to the disease itself and often due to treatments like chemotherapy, which suppress bone marrow function.
Protective precautions (also called neutropenic precautions or reverse isolation) are specifically designed to protect these vulnerable patients from pathogens in the environment.
These measures include placing the patient in a private room, enforcing strict hand hygiene for all who enter, wearing masks, and restricting potentially contaminated items like fresh flowers or raw foods.

Option B: Droplet precautions are used to prevent the spread of infection FROM a patient who has a disease transmitted by large respiratory droplets (e.g., influenza, mumps). The goal here is to protect the patient, not others.
Option C: Airway precaution is not a standard, recognized category of transmission-based isolation precautions like Contact, Droplet, or Airborne. It is a general term related to patient safety and airway management.
Option D: Contact precautions are used to prevent the spread of infection FROM a patient with a known or suspected illness transmitted by direct or indirect contact (e.g., MRSA, C. difficile). The focus is on preventing transmission to others.

Clinical Relevance

Nursing practice connection: Knowing Infection control precautions for immunocompromised patients helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a critical role in maintaining the integrity of the protective environment, which includes meticulous hand hygiene, using appropriate PPE, and educating the patient, family, and other staff.
A key nursing responsibility is to monitor for subtle signs of infection. Immunocompromised patients may not mount a typical inflammatory response, so signs like redness, swelling, and high fever might be minimal or absent.
Patient and family education is vital. They must understand the reasons for the precautions and how to participate, such as performing hand hygiene and screening visitors for illness.

How to Approach the Question

First, analyze the clinical information provided in the question: the patient has leukemia and a WBC count of 3000.
Interpret the lab value. A WBC of 3000 is below the normal range, indicating leukopenia and a compromised immune system.
Identify the primary goal of the intervention. The question asks how to 'prevent infection' in this patient, meaning the goal is to protect the patient from outside germs.
Evaluate each option based on its purpose. Differentiate between precautions that protect the patient (protective/reverse isolation) and those that prevent the patient from spreading an infection to others (contact, droplet, airborne).
Select the option that specifically addresses the need to shield an immunocompromised patient from environmental pathogens.

Concept Tested & Keywords

Concept Tested: Infection control precautions for immunocompromised patients.
Stem keywords: leukemia, WBC count, 3000, prevent infection
Lead-in keywords: Which precaution
Clinical cues: A WBC count of 3000/mm³ signifies leukopenia, indicating a compromised immune system and high risk for infection.

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