Question

A nurse is reviewing the white blood cell count with differential for a client receiving chemotherapy for cancer. Which finding alerts the nurse to the possibility of sepsis?

1) Total white blood cell count is 9000/mm³.
2) Lymphocytes outnumber basophils.
3) 'Bands' outnumber 'segs'.
4) Monocyte count is 1800/mm³.

Answer 1

The possibility of sepsis in a patient receiving chemotherapy is indicated by an increase in immature neutrophils or 'band' cells outnumbering mature neutrophils or 'segs'. This condition is known as a left shift and suggests a severe infection.

Step-by-step explanation:

The finding that alerts the nurse to the possibility of sepsis in a client receiving chemotherapy for cancer is option 3: 'Bands' outnumber 'segs'. This condition can happen when the body is fighting a severe infection, like sepsis, leading to the release of immature neutrophils, also known as band cells or band neutrophils, into the blood. Sepsis is a concern for patients undergoing chemotherapy because their immune systems are often weakened, making them more susceptible to infections. When band cells are elevated, this is referred to as a 'left shift,' which means there is an increase in the number of young, immature white blood cells in response to infection. As for the other options, a total white blood cell count of 9000/mm³ is within the normal range, lymphocytes typically outnumber basophils, and a high monocyte count (1800/mm³) might indicate an infection but is less specific than a left shift for sepsis.