Author Question: A nurse is caring for an African American patient who has been admitted to the unit for long-term ... (Read 89 times)

joe · **on:** Jul 23, 2018

A nurse is caring for an African American patient who has been admitted to the unit for long-term antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice.

The nurse would be correct to suspect that the patient has developed: a. Stevens-Johnson syndrome.
b. kernicterus.
c. hepatotoxicity.
d. hemolytic anemia.

Question 2

A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before adminis-tering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103F, and a heart rate of 100 beats per minute.

The patient looks ill and reports not feeling well. What will the nurse do? a. Administer the dose and request an order for an antipyretic medication.
b. Withhold the dose and request an order for an antihistamine to treat the rash.
c. Withhold the dose and notify the provider of the symptoms.
d. Request an order for intravenous TMP/SMZ, because the patient is getting worse.

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

Answer to Question 1

D
Sulfonamides can cause hemolytic anemia in patients of African American and Mediterranean origin, usually because of a genetic deficiency. Red cell lysis can produce fever, pallor, and jaundice, and patients should be observed for these signs. The patient's signs and symptoms are not characteristic of Stevens-Johnson syndrome or hepatotoxicity. The patient's signs and symp-toms are not characteristic of kernicterus, which occurs in newborns.

Answer to Question 2

C
The most severe hypersensitivity reaction with TMP/SMZ is Stevens-Johnson syndrome, which manifests with fever, malaise, and rash. The drug should be discontinued immediately if a rash occurs. Requesting an antipyretic while giving the drug is incorrect. Giving antihistamines is not indicated. Giving TMP/SMZ intravenously would make the reaction worse.