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LEUCOPENIA
Definition: Leucopenia, a condition in which there are fewer WBCs than normal, results from neutropenia (diminished neutrophils) or lymphopenia(diminished lymphocytes).
Even if other types of WBCs (eg, monocytes, basophils) are diminished, their numbers are too few to reduce the total WBC count significantly
LYMPHOPENIA
LYMPHOCYTES
Lymphocytes less than 1500/mm3: Can result from ionizing radiation, a. Long-term use of corticosteroids, b. Uremia, c. Neoplasms (e.g, breast and lung cancers, advanced Hodgkins disease), and d. Some protein-losing enteropathies (in which the lymphocytes within the intestines are lost).
NEUTROPENIA-
NEUTROPHILS
Neutrophils less than 2000/mm3 Causes: 1.Decreased Production of Neutrophils Aplastic anemia, due to medications or toxins Metastatic cancer, lymphoma, leukemia Myelodysplastic syndromes Chemotherapy Radiation therapy
NEUTROPENIA-CAUSES
2.Increased Destruction of Neutrophils Hypersplenism Medication-induced* Immunologic disease (e.g, systemic lupus erythematosus [SLE]) Viral disease (eg, infectious hepatitis) Bacterial infections
NEUTROPENIA
MEDICAL MANAGEMENT
Management varies depending upon its cause. If neutropenia is medication induced, the offending agent needs to be stopped, if possible. The use of growth factors such as G-CSF or granulocyte/macrophage colony-stimulating factor (GM-CSF) can be effective in increasing neutrophil production when the cause of the neutropenia is decreased production. Corticosteroids may be used if the cause is an immunologic disorder.
MEDICAL MANAGEMENT
Withholding or reducing the dose of chemotherapy or radiation therapy may be required when the neutropenia is caused by these treatments; however, in the case of potentially curative therapy, administration of growth factor is considered to be preferable, so that the maximum antitumor effect can be achieved. Broad-spectrum antibiotics
NURSING MANAGEMENT
Preventing and managing infectious and complications. Patient teaching. Patients at risk for neutropenia should have blood drawn for CBCs Nurses need to be able to calculate the ANC and to assess the severity of neutropenia and the risk for infection
6.Identify appropriate behaviors to take to prevent infection Maintain good hand hygiene technique, total body hygiene, and skin integrity. Avoid fresh flowers, plants, garden work (soil), bird cages, and litter boxes. Avoid fresh salads and unpeeled fruits or vegetables. Maintain a high-calorie, high-protein diet, with fluid intake of 3000 mL (unless fluids are restricted). Avoid people with infections, crowds. Perform deep breathing, use incentive spirometer every 4 hr while awake. Provide adequate lubrication with gentle vaginal manipulation during sexual intercourse.