A patient with acute leukemia develops a temperature of 38.6°C (101.5°F). What is the priority nursing action?

In a patient with acute leukemia, fever is a medical emergency that requires immediate provider notification. Leukemia and its treatment cause profound neutropenia, leaving the patient with little to no immune defense against infection. A temperature of 38.6°C (101.5°F) in a neutropenic patient is considered febrile neutropenia — a life-threatening condition that requires rapid assessment, blood cultures, and broad-spectrum antibiotic administration, typically within 60 minutes of fever onset. Delaying this response significantly increases the risk of septic shock and death. Encouraging oral fluids is a supportive measure but does not address the underlying urgency. Applying cooling measures may reduce fever symptoms but does not treat the cause and should not take priority over notifying the provider. Administering acetaminophen alone is similarly insufficient as a first response because it only reduces fever temporarily while the underlying infection may progress. The nurse's priority is always to recognize the critical nature of the situation and escalate to the provider so that diagnostic workup and empirical antibiotic therapy can be initiated without delay. Febrile neutropenia protocols exist precisely because of how rapidly this condition can deteriorate.