A patient telephones a nurse and reports that since beginning ribavirin (Rebetol) therapy 6 months ago, the patient has had increasing fatigue. Over the past week, shortness of breath also has developed. Which instruction should the nurse provide?
a. "Come to the office for a complete blood count immediately."
b. "This is a normal response to this medication. It should resolve spontaneously in a few days."
c. "Fatigue and shortness of breath may indicate an allergic reaction to the drug. Take an antihistamine."
d. "Break the pills in half to reduce possible side effects."
A
The principal concerns with ribavirin are hemolytic anemia and birth defects. The nurse should instruct the patient to come in for a CBC, because the signs and symptoms are consistent with hemolytic anemia.
The patient's symptoms are not a normal response to the medication.
Fatigue and shortness of breath will not be fixed by administration of an antihistamine.
The medication dosage may be reduced, but the priority is to have the patient come in imme-diately for a blood test.
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