Neutropenia: Nursing

00:00 / 00:00
Transcript
Neutropenia refers to an abnormally low number of neutrophils in the blood. Normally, neutrophil count ranges from 2500 to 7500 neutrophils per microliter, but with neutropenia, it’s usually less than. 1500 neutrophils per microliter of blood. Remember that neutrophils are a subtype of white blood cells that fight off bacterial and fungal infections, so with neutropenia, individuals are at higher risk of developing these infections.
Let’s start with some basic physiology of neutrophils. These cells are created in the bone marrow, from hematopoietic stem cells, which give rise to all types of blood cells. Now, once neutrophils are formed, they leave the bone marrow and enter the bloodstream, where they have an important role in the innate immune response against bacterial and fungal pathogens. Specifically, they fight foreign pathogens by phagocytosis, which is a process of ”ingesting” them into the cell. And next, they digest them inside the cell!
Ok, now, neutropenia can be caused by conditions like infections, when neutrophils are used up faster than they can be produced; as well as autoimmune conditions like systemic lupus erythematosus, which is associated with increased neutrophil destruction. Alternatively, neutropenia can occur because of inefficient bone marrow production, which can be seen in hematologic conditions like aplastic anemia or leukemia. Finally, neutropenia can occur because of an infection that weakens the immune system, such as AIDS; or as a side effect of some medications, including antibiotics like carbapenems and cephalosporins; and chemotherapeutic agents, which are medications used to treat cancer.
Now, with fewer neutrophils in the blood, the immune system can’t fight infections effectively, and this results in recurrent infections. The most common bacterial infections are caused by Staphylococcal, Streptococcal, and E. coli species, while the most common fungal infection is caused by Candida albicans. Finally, even though the overwhelming majority of infections in neutropenia are caused by bacteria or fungi, some viral infections, like herpes simplex or herpes zoster, also occur more frequently with neutropenia. Finally, it's important to note that these infections can cause life-threatening complications, such as sepsis, septic shock, or even death.