A patient with cancer is taking rasburicase (Elitek) to treat hyperuricemia and develops neutropenia with fever and respiratory distress on the fourth day of treatment. The nurse caring for this patient will expect to:
a. administer allopurinol instead of rasburicase.
b. continue giving the drug and monitor the patient's symptoms closely.
c. tell the patient that this drug should never be used again.
d. tell the patient that these symptoms indicate severe sepsis.
Question 2
A previously healthy patient develops sepsis. The patient's lab tests reveal deterioration of renal and hepatic function, and the provider orders drotrecogin alfa (Xigris) to be given intravenously at a rate of 1,440 mcg per hour for 96 hours.
The patient, who weighs 60 kg, has a history of myocardial infarction and takes 81 mg of aspirin daily. What will the nurse do?
a. Administer the medication and monitor vital signs, level of consciousness, and abdominal discomfort.
b. Contact the provider and request discontinuation of the order since drotrecogin alfa is contraindicated with aspirin.
c. Notify the provider that the patient takes aspirin and ask that the medication dose be decreased to 720 mcg per hour.
d. Prepare to administer infusions of platelets while giving the drotrecogin alfa.
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