A patient is receiving interferon alpha (Roferon-A) ...

[altibaby]

A patient is receiving interferon alpha (Roferon-A) subcutaneously. The patient experiences chills, fatigue, and malaise, and the nurse assesses a temperature of 102 F.
 
  The nurse will notify the provider of the temperature and will anticipate which order?
  a. Administer acetaminophen (Tylenol).
  b. Change to intravenous interferon alpha.
  c. Give diphenhydramine (Benadryl).
  d. Obtain a serum BUN and creatinine level.

Question 2

The nurse performs a medication history on a patient who will begin targeted therapy for cancer with gefitinib (Iressa). The nurse learns that the patient is taking carbamazepine, a histamine2 blocker, and warfarin.
 
  The nurse will anticipate that the provider will make which change to the medication regimen?
  a. decrease the gefitinib dose.
  b. decrease the warfarin dose.
  c. increase the histamine2 blocker dose.
  d. increase the carbamazepine dose.

[dominiqueenicolee]

Answer to Question 1

ANS: A
The major side effects of interferon are flulike symptoms with chills, fever, fatigue, malaise, and myalgia. Acetaminophen is given to treat this initially. Changing to an IV form does not alter the side effects. Diphenhydramine is given for nausea caused by interferon alpha. It is not necessary to obtain laboratory work when these symptoms initially occur.

Answer to Question 2

ANS: B
When patients taking warfarin take gefitinib, the effectiveness of the warfarin is greatly increased, and bleeding risks increase. Carbamazepine and histamine2 blockers decrease the effectiveness of gefitinib, so decreasing the gefitinib dose or decreasing the carbamazapine or histamine2 blocker is not recommended.