Be on the alert for signs and symptoms of sepsis and septic shock, such as chills, rigors, temperature spike, hypotension, and tachycardia. If you suspect sepsis, notify the physician and obtain a chest X-ray and stat blood and urine cultures. If prescribed, administer antibiotics and antipyretics to provide comfort, but be cautious not to mask a fever, which may be the only sign of neutropenia. Teach the patient which signs and symptoms to report to her health care provider. Instruct her to reduce the risk of infection by avoiding crowded places, sick people, and pet excretions and by eating nutritionally balanced meals.
Anemia is a less common result of bone marrow depression.
If anemia occurs, it usually happens about 3 months after treatment and is more likely to develop in patients receiving cisplatin, an alkylating agent. Assess your patient's hemoglobin and hematocrit levels before and periodically during treatment, and monitor Spo 2 and arterial blood gases. If prescribed, administer a transfusion of packed RBCs and monitor the patient for complications. Administer erythropoietin as prescribed and teach the patient how to self-administer this drug. Teach the patient to eat foods high in iron and to change positions slowly to avoid dizziness from orthostatic hypotension.