Question

A tech receives a request for a patient to receive Sm153 for palliation of pain from bone mets. the patient has a WBC count of 3500 and 40000 platelets. what should happen next?

a. the order should be changed to Sr89
b. the tx should be delayed until the platelet ct is at least 60,000
c. the tx should be delayed until the WBC is below 2400
d. the Sm153 should be ordered

Answer 1

The treatment with Sm153 should be delayed until the patient's platelet count is at least 60,000 to minimize the risk of bleeding and other complications due to the exacerbation of thrombocytopenia from the therapy.

Step-by-step explanation:

A technician has received a request for a patient to receive Sm153 for palliation of pain from bone metastases. However, given the patient's white blood cell (WBC) count of 3500 and a platelet count of 40000, the appropriate action would be to delay the treatment until the platelet count is at least 60,000. This is because cancer therapies, including radiopharmaceuticals like Samarium-153 (Sm153), can exacerbate thrombocytopenia (low platelet count) and increase the risk of bleeding and other complications. If the patient were to undergo therapy with their current platelet levels, they might be at increased risk of these adverse effects. It is not indicated to switch to another radiopharmaceutical such as Sr89 without further clinical justification and evaluation specifically concerning the benefits and risks associated with Sr89 versus Sm153 in the context of the patient's current hematological status.

Answer 2

The patient should not receive Sm153 due to their low WBC and platelet count. Option B is correct: the treatment should be delayed until the platelet count is at least 60,000.

Step-by-step explanation:

The patient should not receive Sm153 for palliation of pain from bone mets due to their low WBC count and low platelet count. A WBC count below 2400 indicates a compromised immune system and increases the risk of infection. Additionally, a platelet count below 60,000 suggests a higher risk of bleeding and bruising.

Therefore, option B is correct: the treatment should be delayed until the platelet count is at least 60,000.