You are a nurse at a university health clinic. Twenty-year-old T.Q. comes in and informs you he is a new student and he has an immunodeficiency problem
He gives you a letter from his attending physician, hands
you a vial of gamma globulin, and asks you to give him his "shot." The letter from T.Q.'s physician states
T.Q. was diagnosed with primary immunodeficiency disease (PIDD) at age 2 . He has an adequate number
of B cells, but they fail to mature properly and become plasma cells or immunoglobulin. T.Q. states he has
a history of chronic respiratory and gastrointestinal infections. He is maintained on 0.66 mL/kg of gamma
globulin (GamaSTAN) given intramuscularly every 3 weeks and has tolerated this well. He has no known
drug allergies (NKDA). His vital signs are stable.
Can you honor T.Q.'s prescription? Why or why not? How could you provide him with his
injection?
• Verify that T.Q. is a currently enrolled student. Determine when the prescription was written
and whether T.Q.'s physician resides in your state. A prescription from another state might not
be honored across state lines. Check the laws in your state. If T.Q. is from out of state, inform the
center's provider.
• The provider should contact T.Q.'s physician to obtain a copy of T.Q.'s medical records and medical
treatment plan. The provider can consult the treating physician and then prescribe the appropriate
drug, dose, and frequency of injection for T.Q.
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