Neutropenic Nia — Neutropenia & Chemotherapy Precautions
ANC < 500, temp ≥ 100.4°F — a single fever is an emergency
Nia feels 'just tired' the week after her infusion and almost skips her temperature check. The thermometer reads 100.6°F, and everything moves fast after that.
Nia finished her third round of chemotherapy and her bone marrow is wiped out. Her absolute neutrophil count (ANC) has fallen below 500/mm³, leaving her almost no defense against infection. In neutropenia, fever is the only warning sign the body can give — there is often no pus, no redness, no classic infection picture. A single temperature of 100.4°F (38°C) or higher is treated as sepsis until proven otherwise, and antibiotics must start within one hour.
Read Neutropenic Nia's full story →The story arc
The setup
Chemotherapy knocks down every fast-dividing cell in Nia's body, including the neutrophils in her bone marrow.
The turn
She feels washed out and achy but has no cough, no burning with urination, nothing obvious to point to.
The crisis
Her temperature reads 100.6°F. Her ANC from this morning's labs is 380/mm³.
The save
The nurse calls the provider immediately, blood cultures are drawn from two sites, and broad-spectrum IV antibiotics are hung within the hour — before the culture results are even back.
NCLEX study section — Neutropenia & Chemotherapy Precautions
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Safety & Infection Control
Take this chapter into practice questions on the same topic.