The nurse calculates the absolute neutrophil count (ANC) using Band percent plus Seg percent times total WBC. If the CBC shows WBC 1.5 x 10^3/µL with bands 3% and seg 29%, what is the ANC and classification?

• A. 980; mild neutropenia
• B. 480; severe neutropenia
• C. 1500; normal
• D. 120; severe neutropenia

Answer: (B)

Neutrophil count in the blood is the total white blood cell count multiplied by the fraction of neutrophils, which comes from the sum of bands and segs in the differential. Here, bands are 3% and segs 29%, totaling 32%. Convert to a decimal (0.32) and multiply by the total WBC (1.5 x 10^3/µL): 1.5 x 10^3 x 0.32 = 0.48 x 10^3/µL, which is 480 neutrophils per microliter. Classification uses ANC thresholds: normal is about 1500 or higher, mild neutropenia 1000–1499, moderate 500–999, and severe below 500. With an ANC of 480/µL, this is severe neutropenia, indicating high infection risk and need for appropriate clinical management.