Author Question: Mitoxantrone (Novantrone) is prescribed for a 24-year-old woman with relapsing-remitting multiple ... (Read 23 times)

mpobi80 · **on:** Jul 23, 2018

Mitoxantrone (Novantrone) is prescribed for a 24-year-old woman with relapsing-remitting multiple sclerosis. In preparing a teaching plan for this patient, which question would be most pertinent for the nurse to ask?

a. How are you managing contraception?
b. Have you ever experienced an eating disorder?
c. Do you experience spotting between menstrual periods?
d. Did you have facial acne during adolescence?

Question 2

A nurse administered glatiramer (Copaxone) just 10 minutes ago. The patient calls the nurses' station to report itching.

Upon assessment the nurse notes that the patient is flushed and has palpitations, anxiety, and chest pain. What action should the nurse take first?
a. Explain to the patient that the symptoms occur with some patients and will pass within 15 to 20 minutes.
b. Prepare to administer epinephrine, because the patient is experiencing the onset of anaphylaxis.
c. Prepare the crash cart.
d. Elevate the head of the bed, apply oxygen, and maintain the airway.

komodo7 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
Mitoxantrone has the potential for fetal harm and is classified by the U.S. Food and Drug Administration (FDA) as a pregnancy risk category D drug. Before beginning treatment with mitoxantrone, the patient should have a pregnancy test.
The medication can cause nausea and vomiting; however, these symptoms are not related to an eating disorder history.
The medication can cause menstrual irregularities and amenorrhea, therefore the question about spotting between menstrual periods is important, but it is not the most important question to ask.
Adolescent facial acne is not relevant.

Answer to Question 2

ANS: A
About 10 of patients who receive glatiramer experience self-limited, postinjection reactions, characterized by flushing, palpitations, severe chest pain, anxiety, laryngeal constriction, and urticaria. The reaction typically does not last longer than 15 to 20 minutes, but the patient should be monitored.
The symptoms described are expected and do not indicate anaphylaxis, therefore epinephrine should not be administered.
The symptoms do not indicate an emergency situation, therefore the crash cart is not needed.
The symptoms do not indicate anaphylaxis, therefore no treatment is required at this time.
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