WBC Count: Leukocytosis (Nursing)

00:01 So let's go through this one more time with leukocytosis.

00:04 That's a white cell count above 10,000.

00:07 Well, "leuko" means white cell, "cytosis" means extra, right? So we know that normal for an adult is 5,000-10,000, or you may hear us say "5-10," and it's usually due to an increase in one of the 5 types of white blood cells.

00:23 Now that's really important.

00:25 When I have an elevated white cell count above 10,000, it's usually due to an increase in one of the 5 types.

00:34 Now, just for fun, see if you can remember how many of the 5 types you can name without looking at your notes.

00:40 Okay, try and write them in your margin real quick.

00:47 Okay, no cheating. We need you to really work on that with me because that's going to help your brain remember and recall things.

00:55 So we've got leukocytosis, a white cell count above 10,000, because we know that's the top of the normal range for an adult.

01:01 It's usually due to an increase of one of the 5 types of white blood cells.

01:07 Now, we give it the name of the cell that shows the primary increase.

01:11 I know that sounds a little tricky right now, but it's really straightforward.

01:14 Let me make this clear.

01:17 If I have the neutrophils elevated, I have neutrophilic leukocytosis.

01:23 We already know that leukocytosis means extra white cells, but this is telling me neutrophilic leukocytosis, so the one type of white cell that's elevated, are the neutrophils.

01:34 Now, it follows the same pattern all the way through.

01:37 Lymphocytic leukocytosis is lymphocytosis.

01:41 That means I have extra of the lymphocytes.

01:45 Eosinophilic leukocytosis is eosinophilia.

01:49 Now, that's a number you should try out on your family.

01:52 Just walk by and if they ask you what you've been studying, say, "Well, you know, I've been looking at eosinophilic leukocytosis." Just see what they think. It's kind of fun to impress them with those big words.

02:01 Monocytic leukocytosis is monocytosis.

02:06 And last of the 5, basophilic leukocytosis is basophilia.

02:11 Okay, those are some pretty big words, but it's most important that you understand, they identify which one of the 5 types of white blood cells are elevated.

02:23 Let's look at what happens when the white blood cells respond to an attack, because white blood cells release the colony stimulating factor.

02:31 Now we've called that CSF. That's not cerebral spinal fluid.

02:35 We're talking about colony stimulating factor.

02:39 So you see our 5 types of white blood cells there.

02:42 Now the body is under attack, so the white blood cells will release colony stimulating factor. Now its job will tell the bone marrow, "Hey, guys, pick it up. We need you to increase the white blood cell production." So your body's attacked.

02:57 The white blood cells release colony stimulus factor.

03:01 The colony stimulating factor tells the bone marrow to increase the white cell production.

03:06 Now, here's the cool part. Look at this.

03:10 The normal bone marrow can double the white blood cell count within hours.

03:15 Okay, that is phenomenal. Stop and think about that for just a minute.

03:20 Within just a few hours, you can completely double a normal white blood cell count in response to infection.

03:27 That's why our immune system can fight off some pretty big bugs if it's healthy and functioning the way it was intended to.

03:36 So, leukocytosis. Remember we said it's usually not increased in all 5 types of white blood cells.

03:41 If you notice that all 5 of them are increased, consider dehydration and hemoconcentration.

03:48 When a patient is pretty significantly dehydrated, their blood becomes super concentrated, and that's an indication when all 5 of the white blood cells are elevated.

03:59 So you're going to want to look at their fluid volume status. You'll look at their sodium.

04:02 Kind of get a feel for if we think they're intra-vascularly dehydrated.

04:07 That could be a sign if all 5 types of the white blood cells are elevated.

04:11 Now, also with a dramatic white blood cell increase, you might think about measles, pertussis, or sepsis.

04:19 These will be temporary increases in a dramatic white blood cell increase.

04:24 But you have this dramatic increase. It might also be something similar to leukemia, which would be more permanent and progressive.

04:31 So, if I have all 5 types of white blood cells elevated, I'm thinking, "Huh, is my patient dehydrated and therefore hemoconcentrated?" Otherwise, if I have a dramatic white blood cell increase, I want to think about measles, pertussis and sepsis, or there may be something like leukemia that's going on.