A patient develops hemolytic anemia after receiving a dose of ...

[jeatrice]

A patient develops hemolytic anemia after receiving a dose of penicillin. What action should the nurse realize is indicated for this patient?
 
  1. Administer no further doses of penicillin.
  2. Administer a blood transfusion.
  3. Provide oxygen.
  4. Increase fluids.

Question 2

A patient who has received a bone marrow transplant develops a maculopapular rash on the palms of both hands and the soles of the feet. The patient complains of severe abdominal pain with bloody diarrhea.
 
  What should the nurse suspect this patient is experiencing?
 
  1. graft-versus-host disease
  2. chronic tissue rejection
  3. acute tissue rejection
  4. hyperacute tissue rejection

[juicepod]

Answer to Question 1

Correct Answer: 1

Type II reactions may be stimulated by a drug reaction in which the drug forms an antigenic complex on the surface of a blood cell, stimulating the production of antibodies. The affected cell is then destroyed in the resulting antigenantibody reaction. Hemolytic anemia is sometimes associated with the administration of drugs such as penicillin. Withdrawal of the drug stops the reaction and cell destruction. A blood transfusion, oxygen, or fluids will not stop the reaction.

Answer to Question 2

Correct Answer: 1

In a transplant patient, a maculopapular pruritic rash beginning on the palms of the hands and soles of the feet indicates graft-versus-host disease. The rash can spread to involve the entire body and lead to desquamation. Gastrointestinal manifestations include abdominal pain, nausea, and bloody diarrhea. Chronic tissue rejection occurs from 4 months to years after the transplant of new tissue. Acute tissue rejection is the most common type of rejection, and occurs between 4 days and 3 months after the transplant. Acute rejection is mediated primarily by the cellular immune response, resulting in transplant cell destruction. The patient experiencing rejection demonstrates manifestations of the inflammatory process, with fever, redness, swelling, elevated BUN, creatinine, lower enzymes, and elevated bilirubin and cardiac enzymes. Hyperacute tissue rejection leads to rapid deterioration of organ function.