A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the provider to discuss:
a. administering epinephrine.
b. changing to a first-generation NSAID.
c. reducing the dose of aspirin.
d. giving an antihistamine.
ANS: A
Aspirin can cause a hypersensitivity reaction in some patients. This may start with profuse, water rhinorrhea and progress to generalized urticaria, bronchospasm, laryngeal edema, and shock. It is not a true anaphylactic reaction, because it is not mediated by the immune system. Epinephrine is the treatment of choice. Patients with sensitivity to ASA often also have sensitivity to NSAIDs; the first indication with this patient is to treat the potential life-threatening effect, not to change the medication. Reduction of the dose of ASA is not indicated, because this reaction is not dose dependant. Antihistamines are not effective, because this is not an allergic reaction.
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