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Author Question: A patient who is taking azathioprine Imuran to prevent rejection of a renal transplant develops gout ... (Read 117 times)

EAugust

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on: Jul 23, 2018
A patient who is taking azathioprine Imuran to prevent rejection of a renal transplant develops gout and the provider orders allopurinol. The nurse will contact the provider to discuss:
 
  a. decreasing the allopurinol dose.
  b. decreasing the azathioprine dose.
  c. increasing the allopurinol dose.
  d. increasing the azathioprine dose.

Question 2

A patient is diagnosed with an infection caused by Staphylococcus aureus, and the prescriber orders intravenous gentamicin and penicillin (PCN). Both drugs will be given twice daily. What will the nurse do?
 
  a. Administer gentamicin, flush the line, and then give the penicillin.
  b. Give the gentamicin intravenously and the penicillin intramuscularly.
  c. Infuse the gentamicin and the penicillin together to prevent fluid overload.
  d. Request an order to change the penicillin to vancomycin.


ririgirl15

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Reply #1 on: Jul 23, 2018
Answer to Question 1

B
Allopurinol delays conversion of mercaptopurine to inactive products and increases the risk of azathioprine toxicity. Patients taking the two concurrently should have an approximate 70 re-duction in the azathioprine dose. Altering the allopurinol dose is not indicated.

Answer to Question 2

A
Gentamicin should not be infused with penicillins in the same solution, because PCN inactivates gentamicin; therefore, the nurse should give one first, flush the line, and then give the other. The nurse cannot give a drug IM when it is ordered IV without an order from the prescriber. These two drugs should not be infused in the same solution. There is no indication for changing the PCN to vancomycin; that should be done for serious infections.


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EAugust

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


ririgirl15

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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