Neutropenia and Infection Management Flashcards
5 cards from real CPHON practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 5 Neutropenia and Infection Management flashcards as text
When a febrile neutropenic child presents to the emergency department, what is the maximum acceptable time from triage to first antibiotic dose according to best practice guidelines?
Answer: 60 minutes (1 hour)
Pediatric oncology guidelines and sepsis bundles mandate that the first dose of empiric broad-spectrum antibiotics be administered within 60 minutes of triage for febrile neutropenia, prior to obtaining all diagnostic results except blood cultures.
A child receiving ALL consolidation therapy is admitted for febrile neutropenia. Cultures are negative at 48 hours and the child appears clinically well with declining fever. The nurse anticipates the team will:
Answer: Continue IV antibiotics until ANC recovers to >500/µL and the patient is afebrile for 48+ hours
Standard febrile neutropenia management continues IV antibiotics until the ANC recovers to ≥500/µL and the patient has been afebrile for at least 48 hours, even if cultures remain negative, because neutropenic patients cannot mount adequate immune responses.
A nurse is educating the parents of a neutropenic child about infection precautions at home. Which teaching point is INCORRECT and must be corrected?
Answer: 'It is fine to use alcohol-based hand sanitizer instead of soap and water if your child has a C. difficile infection'
Alcohol-based hand sanitizers do NOT kill Clostridium difficile spores. For C. diff-positive patients and their caregivers, soap and water handwashing is mandatory because mechanical friction physically removes spores that alcohol cannot kill.
A child with AML has been neutropenic for 18 days and develops a new pulmonary infiltrate on chest X-ray. Serum galactomannan test returns positive. The nurse should prepare for which treatment?
Answer: Initiation of voriconazole IV as first-line antifungal therapy for invasive aspergillosis
A positive galactomannan (a fungal cell wall polysaccharide marker) in a prolonged neutropenic AML patient with new pulmonary infiltrate indicates probable invasive aspergillosis. Voriconazole is the FDA-approved, guideline-recommended first-line agent.
The nurse is reviewing discharge instructions for a child who completed treatment for febrile neutropenia with ANC now 620/µL. The family asks when their child can return to school. The most appropriate response is:
Answer: Consult with the oncology team, as the timing depends on the ANC trend, scheduled next chemotherapy cycle, and absence of fever — general guidance is ANC >500 with upward trend
School return in a pediatric oncology patient requires individualized assessment by the oncology team, considering current and projected ANC, upcoming chemotherapy timing, infection exposure risk at school, and vaccination status of classmates.