Fever patterns in the neutropenic patient

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Abstract
Neutropenic cancer patients present a challenge to nursing. These patients are at high risk for infection, which, if undetected and untreated can rapidly progress to septic shock and death. Normal clinical signs of infection may be depressed or absent, making detection difficult. Fever (101°F or 38.3°C) may indeed be the only sign of infection in these compromised hosts. An aggressive search for the cause must be initiated at the first sign of fever so that effective therapy can be started. Fever patterns—remittent, intermittent, sustained, and relapsing—though not diagnostic, are useful in monitoring the progress of an infection and the efficacy of therapy. Often, therapy is altered on the basis of the fever pattern, especially when all cultures are negative. Nurses caring for neutropenic cancer patients must frequently and thoroughly assess them to detect even the subtlest change indicative of infection. They must refrain from routinely giving antipyretic drugs, which mask a fever, causing an unnecessary and even life-threatening delay in appropriate antibiotic therapy. Nurses must diligently monitor and graph the temperature pattern. Close communication with the physician will also guarantee that all members of the health care team work together for this special population.

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