Author Question: An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders ... (Read 23 times)

mcmcdaniel · **on:** Jul 23, 2018

An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine (Phenergan). What will the nurse do?

a. Give the medication as ordered.
b. Monitor the child for bronchoconstriction .
c. Question the order.
d. Request an order to give the drug orally.

Question 2

A provider has ordered intravenous promethazine (Phenergan) for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do?

a. Administer the drug at a rate of 25 mg/min or more to achieve maximum effects.
b. Contact the provider to suggest using dimenhydrinate (Dramamine) instead.
c. Ensure that the IV is infusing freely through a large-bore needle.
d. Monitor the patient closely for cardiac dysrhythmias.

lorealeza77 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
Promethazine can cause severe respiratory depression, especially in very young patients; it is contraindicated in children younger than 2 years. The medication should not be given as ordered. It is not safe to give the drug and then monitor for bronchoconstriction . The drug is not safe in this age group when given orally.

Answer to Question 2

ANS: C
Promethazine can cause severe local tissue injury if it extravasates into tissues, so the medication should be administered in an IV that is flowing freely through a large-bore needle. The drug should be administered at a rate of 25 mg/min or less. Dimenhydrinate is indicated for motion sickness, not postoperative N/V. Cardiac dysrhythmias were a concern with two antihistamines no longer on the market, astemizole and terfenadine.