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These should be recorded on an early warning score chart by following this protocol signs of recovery and deterioration can be monitored. Investigations would include full blood count to establish level of neutropenia, Urea and electrolytes to gain renal function as renal failure maybe a complication of myeloma (Howard and Hamilton 1997 p61). Blood cultures should be taken peripheral and from the Hickman line to identify causative organism, most bacterial pathogens isolated from central line blood cultures are gram positive bacteria (Simon et al 2006 p608). A mid stream specimen of urine should also be collected to exclude this as a source of infection...
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