Author Question: A 20-kg pediatric patient is being treated for toxoplasmosis, and the provider orders pyrimetha-mine ... (Read 34 times)

Frost2351 · **on:** Jul 23, 2018

A 20-kg pediatric patient is being treated for toxoplasmosis, and the provider orders pyrimetha-mine Daraprim 10 mg twice daily. The nurse caring for this patient will anticipate which addi-tional order from the provider?

a. Administer 10 to 15 mg of folinic acid with each dose of pyrimethamine.
b. Give the medication intravenously over 30 to 45 minutes.
c. Increase the dose to 20 mg twice daily after 2 to 4 days.
d. Teach the family to monitor for muscle pain and joint stiffness.

Question 2

A patient from Africa is being treated for East African trypanosomiasis. The nurse is preparing to administer a first dose of suramin sodium Germanin. To prevent serious side effects, which ac-tion will the nurse take?

a. Administer a small test dose before giving the drug.
b. Ask the patient to lie flat while the drug is given.
c. Give a high-fat snack with the drug to mi-nimize gastric upset.
d. Suggest to the provider that liver function tests (LFTs) be performed.

kescobar@64 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
Folinic acid is given with pyrimethamine to minimize adverse effects, and the dose is 10 to 15 mg twice daily, given with the pyrimethamine dose. The medication is given orally. The dose should be cut in half, not increased, after 2 to 4 days. Muscle pain and joint stiffness are adverse effects of sodium stibogluconate.

Answer to Question 2

A
Suramin sodium can cause severe side effects, including a shock-like syndrome with IV dosing. A small test dose should be given initially to make sure this is not likely. Patients receiving pen-tamidine should be supine while receiving that drug. It is not necessary to provide a fatty snack with suramin or to obtain LFTs before administration.