A 58-year-old male patient with a history of chemotherapy presents to the emergency department with a temperature of 101.5°F (38.6°C), chills, and general malaise. Based on the patient's presentation, which assessment should be prioritized to most accurately determine the next course of action?
Perform a comprehensive health history to identify potential sources of infection
Assess the patient for other potential sources of infection like urinary or respiratory symptoms
Inspect the IV site for signs of phlebitis or infiltration
Obtain a full set of vital signs and evaluate the patient's neutrophil count
For a patient with a history of chemotherapy presenting with fever and chills, the priority assessment should be obtaining a full set of vital signs followed by a neutrophil count. Chemotherapy can lead to neutropenia, which increases the risk of severe infection. Fever in a neutropenic patient is considered an oncologic emergency and requires prompt evaluation and treatment to prevent sepsis. While a comprehensive health history, inspection of the IV site, and assessing for other sources of infection are also important, these do not take precedence over determining whether the patient is neutropenic, as this would guide the immediate management, including isolation and administration of broad-spectrum antibiotics.
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