Author Question: A nurse is discussing the administration of an intravenous infusion of rituximab (Rituxan) with a ... (Read 33 times)

mckennatimberlake · **on:** Jul 23, 2018

A nurse is discussing the administration of an intravenous infusion of rituximab (Rituxan) with a nursing student. Which statement by the student indicates a need for further education about the care of a patient receiving this drug?

a. Angioedema and hypersensitivity may occur, but they are usually self-limiting and mild.
b. I should be prepared to administer epi-nephrine, glucocorticoids, and oxygen if needed.
c. I will administer an antihistamine and acetaminophen before beginning the infu-sion.
d. I will monitor this patient's blood pres-sure, respiratory rate, and oxygen satura-tion closely.

Question 2

A child who has juvenile idiopathic arthritis and who has been taking methotrexate Rheumatrex will begin a course of abatacept Orencia. What will the nurse include when teaching the child's family about this drug?

a. That abatacept and methotrexate must both be taken to be effective
b. To continue getting vaccinations during therapy with abatacept
c. That signs of infection may warrant im-mediate discontinuation of abatacept
d. That a tumor necrosis factor (TNF) anta-gonist may be added if this therapy is not effective

cam1229 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Rituximab can cause severe infusion-related hypersensitivity reactions. Nurses should be pre-pared to administer epinephrine, steroids, and O2 if needed. Antihistamines and acetaminophen are given before infusion. Close monitoring of vital signs and oxygenation are indicated.

Answer to Question 2

C
Abatacept suppresses immune function and can increase the risk of serious infection. Parents should report any signs of infection, which may warrant discontinuation of abatacept. Abatacept may be taken alone. Abatacept may blunt the effectiveness of vaccines, and vaccines should be up-to-date prior to therapy and may need to be delayed until 3 months after therapy. Live vac-cines should be avoided. Abatacept should not be given with TNF antagonists because of the increased risk of serious infections.