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on 29 October 2013

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Neutropenia exists when there is an absolute decrease in the number of circulating
neutrophils, less than 1.0 (x109/L).

• Febrile neutropenia exists when a patient with
a neutrophil count less than 1.0(x109/L)and has
a temperature greater than or equal to 38.oC,
or if a patient is systemically unwell with a clinical suspicion of sepsis.

Signs and Symptoms
Fever,flu-like symptoms.
Shaking chills, severe night sweats.
Nausea and vomiting.
Tenderness, redness, swelling, pain or
discharge at the site of a catheter.
Headache or neck stiffness.

Patients should take these symptoms very
seriously, especially fever,
and you should visit your local
emergency room or contact your oncology
team immediately.

prognosis and prevalence
Is a life-threatening emergency.
• About 70%-75% of deaths from acute leukemia
• About 50% of deaths in patients with solid tumors are related to infection
secondary to neutropenia (Nirenberg, Mulhearn, Lin, and Larsen 2004).

Complications of febrile neutropenia often result:
• in chemotherapy dose reductions
• in therapy delays can compromise treatment outcomes

nursing implications
Prevention of infection
Interventions at the highest level of recommendation:
• Hand hygiene with soap and water of alcohol-based rubs.
• Gown by caring for pt with respiratory secretions.
• Closed windows in healthcare facilities.
• Restrictions for visitors with respiratory symptoms
Tawana Eaford RN, Barbara Melena RN,BSN,OCN
Grade 1 < 1500/mm3
Grade 2 < 1500-1000/mm3
Grade e < 1000-500/ mm3
Grade 4 < 500/mm3
Profound Neutropenia < 100ml
Pround impairment in the inflammatory response leading to decresed signs of infection.

Decrease production of infection fighting cells in the bone marrow (neutrophils).

congenital, diseases of the bone marrow, chemotherapy, radiation, viral infections, immune system diseases, and certain medications.

Oncology nurses play a vital role in providing chemotherapy
side-effect education to:
• patients
• their caregivers
Patient education includes teaching about:
• the potential of neutropenia
• the consequences of neutropenia
• preventive measures to decrease the risk of infection
• signs and symptoms of infection
• what to do when signs and symptoms occur

patient education
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