The nurse assesses and reviews the laboratory results for 4 clients. Which client's fever is of highest priority and should be reported to the health care provider immediately?

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A common adverse effect of chemotherapy is bone marrow suppression (eg, anemia, leukopenia, thrombocytopenia) and immunosuppression. A decreased neutrophil (type of white blood cell) count, termed neutropenia, increases the client's susceptibility to infection. A fever can signal an infection and, in the presence of neutropenia (ie, neutropenic fever), can rapidly develop into life-threatening sepsis. Even a low-grade fever should be taken seriously in these clients. (Option A) Hodgkin lymphoma is a malignant cancer of the lymphatic system. Expected early manifestations include painless enlarged lymph nodes, fatigue, fever, weight loss, and drenching night sweats. The client's white blood cell count is within normal limits (4,000-11,000 mm³ [4.0-11.0 × 10⁹/L]). (Option B) Acute cholecystitis involves inflammation of the gallbladder. Expected manifestations include right upper quadrant pain that can radiate to the right shoulder, nausea, vomiting, fever, and leukocytosis (white blood cells count >11,000/mm³ [11.0 × 10⁹/L]). The client is scheduled for surgery and is likely on antibiotics. Even if the client is not on antibiotics, neutropenia is a priority over acute cholecystitis. (Option C) Clostridium difficile is a toxin-producing bacterium that proliferates in the lower gastrointestinal tract. Expected manifestations include diarrhea, fever, and leukocytosis. First-line pharmacologic treatment includes metronidazole (Flagyl) and oral vancomycin. Educational objective: Common adverse effects of chemotherapy are bone marrow suppression (eg, anemia, leukopenia, thrombocytopenia) and immunosuppression. Even a low-grade fever should be taken seriously in clients who are immunosuppressed or have neutropenia.

The Nurse Assesses and Reviews the Laboratory Results for 4