QLexNursing

White blood cell (WBC) count

♦️A WBC count evaluates the body’s inflammatory/immune response, and elevations (e.g., leukocytosis, left shift) support a bacterial infection suspicion.

♦️Trending WBC with differential (neutrophils, bands, lymphocytes) helps distinguish bacterial vs. viral patterns and gauges severity/progression.

♦️It provides a rapid, accessible metric to correlate with vital signs, symptoms, and organ function.

♦️Paired with other markers (e.g., CRP/procalcitonin when available), it strengthens diagnostic confidence and guides therapy.

♦️Serial WBC measurements assist in monitoring response to antibiotics and early detection of deterioration.

Blood culture

♦️Blood cultures identify the causative pathogen and provide antimicrobial susceptibilities, enabling targeted therapy rather than broad empirics.

♦️Obtaining two sets from separate sites before antibiotics maximizes yield and minimizes contamination.

♦️Culture results inform antibiotic de-escalation, reducing resistance, toxicity, and cost.

♦️Positive cultures reveal bacteremia/sepsis, prompting appropriate source control and level of care decisions.

♦️Even if negative, cultures refine the differential diagnosis and guide the duration of therapy.

Hemoglobin A1C

♦️A1C reflects 2–3 months of glycemic control; hyperglycemia impairs neutrophil function, chemotaxis, and phagocytosis, increasing infection risk and delayed healing.

♦️Knowing A1C stratifies host vulnerability, informs glucose targets, and supports glycemic optimization, which improves immune competence and outcomes.

♦️Elevated A1C correlates with higher complication rates (e.g., wound infection, pneumonia severity) and prolonged recovery.

♦️Incorporating A1C into the workup enables a holistic plan (infection control plus metabolic management).

♦️It also guides follow-up, diabetes education, and interdisciplinary referrals to reduce recurrence.