A child with hypogammaglobulinemia is to receive intravenous immunoglobulin (IVIG). What action would not be correct to take?
A) Shake the vial after reconstituting it
B) Premedicate the child with acetaminophen
C) Obtain preinfusion vital signs
D) Check serum blood urea nitrogen and creatinine levels
Ans: A
Many IVIG products are packed as two vials, one the IVIG powder and one the sterile diluents. Once reconstituted, the IVIG should not be shaken because this leads to foaming and may cause the immunoglobulin protein to degrade. The child can be premedicated with acetaminophen or diphenhydramine. Baseline serum blood urea nitrogen and creatinine should be assessed because acute renal insufficiency may occur as a serious adverse reaction.
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