- Deficient Knowledge Related to Inadequate interest in learning and Inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and Development of complications
- Ineffective Protection related to Low neutrophil count and Immunosuppression as evidenced by Deficient immunity and Delayed recovery from infection or injury
- Hyperthermia Related to Infection as evidenced by Skin warm to touch and Chills
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbalizes poor understanding Seeks additional information Objective data: -Inaccurate demonstration or teach-back of instructions -Inability to recall instructions -Exhibiting aggression or irritability regarding teaching follow-up -Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge Related to Inadequate interest in learning and Inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and Development of complications | Patient will verbalize understanding of neutropenia and adhere to the plan of care. Patient will verbalize three neutropenic precautions they can implement at home. | 1. Educate the patient about neutropenia. In simple terms, without medical jargon, educate the patient and family about their lab values and how their numbers drive treatment. 2. Educate the patient about the signs and symptoms of infection. Neutropenic patients have a higher risk of developing infections. Provide the patient with a list of symptoms to monitor for and when to alert their medical team. 3. Educate the patient and family on neutropenic precautions: Limit visitors in the home Wear a mask in public places Avoid crowded stores or restaurants Avoid live plants Maintain good oral health Talk to your doctor before getting vaccines 4. Instruct on food safety. Patients with neutropenia must take care when eating fresh foods and vegetables and they must be thoroughly washed to remove bacteria. Some patients may need to avoid raw fruits and vegetables and undercooked meats. | Patient verbalized about understanding of neutropenia and adhere to the plan of care. Patient verbalized three neutropenic precautions they can implement at home. |
| Subjective data: Verbalizes fear of Infection Objective data: -Fever -Coughing -Dyspnea -Fatigue -Deficient immunity -Delayed recovery from infection or injury | Ineffective Protection related to Low neutrophil count and Immunosuppression as evidenced by Deficient immunity and Delayed recovery from infection or injury | Patient will demonstrate an absolute neutrophil count greater than 1,500 cells/mm3. Patient will verbalize three strategies to protect against infection. Patient will remain free from infection | 1. Implement neutropenic precautions. The patient should be placed in a private room with the door kept closed. Do not allow anyone with an illness to visit. Ensure the patient wears a mask when being transported out of the room. 2. Administer vaccinations and immunizations as ordered. Vaccinations are encouraged to protect the patient against infections and viruses. Ensure vaccinations are inactivated. 3. Avoid invasive procedures. Avoid invasive procedures like rectal temperatures or IM injections that could disrupt the patient’s skin barrier and introduce bacteria. 4. Administer growth factors. Granulocyte colony-stimulating factors can shorten the duration of neutropenia in patients receiving chemotherapy by stimulating the production of granulocytes to increase the patient’s ability to fight infection. 5. Implement proper hygiene practices. Proper handwashing is crucial for all healthcare providers, patients, and anyone who cares for the patient. Aid in other hygiene practices such as frequent oral care and skin care | Patient demonstrated an absolute neutrophil count greater than 1,500 cells/mm3. Patient verbalized three strategies to protect against infection. Patient remained free from infection |
| Subjective data: Verbalizes increased Body Temperature Objective data: -Skin warm to touch -Diaphoresis -Chills -Stupor -Tachycardia -Tachypnea | Hyperthermia Related to Infection as evidenced by Skin warm to touch and Chills | Patient will be able to maintain a body temperature below 100.4 F (38 C). Patient will demonstrate strategies to promote a reduction in temperature. | 1. Administer prescribed medications. Antibiotics and antipyretic medications are given to correct hyperthermia and treat the infection. 2. Encourage nonpharmacologic cooling methods. Reducing the room temperature and removing excess clothing and blankets can help regulate environmental temperature, promoting patient comfort. 3. Assist with imaging and other tests. Lab tests should be ordered to assess for changes, along with a chest x-ray, urinalysis, blood cultures, and sputum swabs, if applicable, before implementing antibiotics to detect the offending pathogen. 4. Keep the patient hydrated. Hyperthermia can affect the patient’s hydration status. Providing adequate fluids can help reduce body temperature. Closely monitor intake and output. 5. Consider delaying treatment. The development of hyperthermia may call for stopping further chemotherapy treatments until the infection is controlled. | Patient maintained a body temperature below 100.4 F (38 C). Patient demonstrated strategies to promote a reduction in temperature. |