A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before adminis-tering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute
The patient looks ill and reports not feeling well. What will the nurse do? a. Administer the dose and request an order for an antipyretic medication.
b. Withhold the dose and request an order for an antihistamine to treat the rash.
c. Withhold the dose and notify the provider of the symptoms.
d. Request an order for intravenous TMP/SMZ, because the patient is getting worse.
C
The most severe hypersensitivity reaction with TMP/SMZ is Stevens-Johnson syndrome, which manifests with fever, malaise, and rash. The drug should be discontinued immediately if a rash occurs. Requesting an antipyretic while giving the drug is incorrect. Giving antihistamines is not indicated. Giving TMP/SMZ intravenously would make the reaction worse.
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