July 19, 2023

White Blood Cell (WBC) Lab Values

3 minutes

Overview

White Blood Cells
1. Normal Value Range
2. Pathophysiology
3. Special considerations
4. Abnormal values (high)
5. Abnormal values (low)

Nursing Points General

Normal value range
1. WBC
  1. 4500-10000/mcL
2. Differential
  1. Neutrophils
    1. 40-60%
  2. Bands
    1. 3-5%
      1. >8% indicates signal to WBC for more production
      2. Infection or inflammation is severe
  3. Eosinophils
    1. 1-4%
  4. Basophils
    1. 0.5-1%
  5. Lymphocytes
    1. 20-40%
  6. Monocytes
    1. 2-8%
Pathophysiology
1. WBC
  1. Formed in the bone marrow
  2. Responsible for responding to foreign invaders
    1. Creating antibodies (immunity)
    2. Phagocytosis (eating bacteria or fungi)
  3. Multiple types with different purposes
    1. Neutrophils –
      1. inflammation and first response to invader
    2. Eosinophils –
      1. Inflammation
      2. Allergic response
      3. Parasites
    3. Basophils
      1. Inflammation
      2. Allergic response
    4. Lymphocytes
      1. Create antibodies
      2. Recognize antigens
      3. Destroy cells
        
        T Cells
        
        B Cells
        
        Natural Killer cells
    5. Monocytes
      1. Macrophages
        
        Engulf and destroy invaders
      2. Indicative of infection
Special considerations
1. Lavender top tube
2. Will commonly be submitted for Complete Blood Count with differential
Abnormal lab values
1. Increased White Blood Cell count (leukocytosis)
  1. Infection
  2. Inflammation
  3. Trauma/Stress
  4. Pregnancy
  5. Asthma
  6. Allergic Reaction
2. Decreased lab values (leukopenia)
  1. Systemic Lupus Erythematosus (SLE)/Rheumatoid arthritis
  2. Cancers
  3. Chemotherapy/Radiation
  4. Medications
    1. Neutropenic precautions
      1. Masks
      2. Gloves
      3. Wash hands
      4. Consider yourself infectious
        
        Prevent spread of infection to the patient

Assessment

Consider the overall WBC count plus abnormalities in differential
1. Evaluate patient
  1. Signs or symptoms of:
    1. Trauma
    2. Inflammation
    3. Infection

Therapeutic Management

Antibiotic therapies where indicated by infection (followed by cultures to determine efficacy of antibiotics)
Anti-inflammatories for inflammation
Provide neutropenic precautions when necessary

Nursing Concepts

Lab Values
Infection Control

Patient Education

Educate patient on the finishing any antibiotics completely. Do not stop prior, even if the patient says they are feeling better.

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By Jon Haws RN: Critical Care Nurse & NCLEX Educator

4.4

129129 ratings

July 19, 2023

White Blood Cell (WBC) Lab Values

3 minutes

Overview

White Blood Cells
1. Normal Value Range
2. Pathophysiology
3. Special considerations
4. Abnormal values (high)
5. Abnormal values (low)

Nursing Points General

Normal value range
1. WBC
  1. 4500-10000/mcL
2. Differential
  1. Neutrophils
    1. 40-60%
  2. Bands
    1. 3-5%
      1. >8% indicates signal to WBC for more production
      2. Infection or inflammation is severe
  3. Eosinophils
    1. 1-4%
  4. Basophils
    1. 0.5-1%
  5. Lymphocytes
    1. 20-40%
  6. Monocytes
    1. 2-8%
Pathophysiology
1. WBC
  1. Formed in the bone marrow
  2. Responsible for responding to foreign invaders
    1. Creating antibodies (immunity)
    2. Phagocytosis (eating bacteria or fungi)
  3. Multiple types with different purposes
    1. Neutrophils –
      1. inflammation and first response to invader
    2. Eosinophils –
      1. Inflammation
      2. Allergic response
      3. Parasites
    3. Basophils
      1. Inflammation
      2. Allergic response
    4. Lymphocytes
      1. Create antibodies
      2. Recognize antigens
      3. Destroy cells
        
        T Cells
        
        B Cells
        
        Natural Killer cells
    5. Monocytes
      1. Macrophages
        
        Engulf and destroy invaders
      2. Indicative of infection
Special considerations
1. Lavender top tube
2. Will commonly be submitted for Complete Blood Count with differential
Abnormal lab values
1. Increased White Blood Cell count (leukocytosis)
  1. Infection
  2. Inflammation
  3. Trauma/Stress
  4. Pregnancy
  5. Asthma
  6. Allergic Reaction
2. Decreased lab values (leukopenia)
  1. Systemic Lupus Erythematosus (SLE)/Rheumatoid arthritis
  2. Cancers
  3. Chemotherapy/Radiation
  4. Medications
    1. Neutropenic precautions
      1. Masks
      2. Gloves
      3. Wash hands
      4. Consider yourself infectious
        
        Prevent spread of infection to the patient

Assessment

Consider the overall WBC count plus abnormalities in differential
1. Evaluate patient
  1. Signs or symptoms of:
    1. Trauma
    2. Inflammation
    3. Infection

Therapeutic Management

Antibiotic therapies where indicated by infection (followed by cultures to determine efficacy of antibiotics)
Anti-inflammatories for inflammation
Provide neutropenic precautions when necessary

Nursing Concepts