1. A client has been receiving IV paclitaxel for the past week for treatment of ovarian cancer. Identify an assessment finding that is a priority to report to the provider? 2. A client with migraines is prescribed sumatriptan. Identify two (2) health concerns where this medication is contraindicated. 3. A 22-year-old client is hard to awake after taking diazepam by mouth. It is suspected she overdosed on the medication. What are two (2) measure the nurse anticipates will take place to address the acute toxicity with diazepam.
1. A potential assessment finding that is a priority to report to the healthcare provider in a client receiving IV paclitaxel for ovarian cancer is the development of any signs or symptoms of an allergic reaction. Paclitaxel is known to cause hypersensitivity reactions, and these reactions can range from mild symptoms such as flushing and rash to severe symptoms such as difficulty breathing and anaphylaxis. It is important for the healthcare provider to be notified immediately if the client experiences any signs or symptoms of an allergic reaction, as prompt intervention is necessary to prevent further complications and provide appropriate treatment.
2. Sumatriptan is a medication commonly used for the treatment of migraines. However, there are certain health concerns where this medication is contraindicated. Two such contraindications include:
a) Uncontrolled hypertension: Sumatriptan can cause constriction of blood vessels, including those in the brain. This may lead to an increase in blood pressure. Therefore, it is contraindicated in individuals with uncontrolled hypertension as it can potentially exacerbate their condition and further increase their blood pressure.
b) Ischemic heart disease: Sumatriptan can also cause constriction of coronary blood vessels, which may lead to a decrease in blood flow to the heart. This can be problematic in individuals with pre-existing ischemic heart disease, as it can potentially worsen myocardial ischemia and increase the risk of cardiac events such as myocardial infarction. Therefore, sumatriptan is contraindicated in individuals with a history of ischemic heart disease.
It is important for healthcare providers to carefully assess the client’s medical history and consider these contraindications before prescribing sumatriptan for the treatment of migraines. In such cases, alternative treatment options may be explored to prevent any potential harm.
3. In the scenario of a suspected diazepam overdose leading to acute toxicity in a 22-year-old client who is difficult to awake, the nurse can anticipate the following measures to address the situation:
a) Airway management and respiratory support: Diazepam, a benzodiazepine medication, can cause central nervous system depression, leading to respiratory depression and even respiratory arrest in high doses. Therefore, the nurse may anticipate that airway management will be a priority to ensure adequate oxygenation and ventilation. This can include providing supplemental oxygen, performing manual ventilation, or intubation if necessary.
b) Administration of flumazenil: Flumazenil is a benzodiazepine receptor antagonist that can reverse the sedative effects of benzodiazepines like diazepam. In cases of acute diazepam toxicity, the nurse can anticipate that flumazenil may be administered intravenously to counteract the excessive sedation and help reverse the overdose symptoms. However, the use of flumazenil should be approached with caution as it can precipitate seizures in individuals who are chronic benzodiazepine users or have a history of seizures.
These measures are aimed at ensuring the client’s airway, breathing, and circulation are maintained and addressing the sedative effects of diazepam. Given the potentially serious nature of diazepam overdose, it is crucial for the nurse to promptly intervene and collaborate with the healthcare team to provide appropriate care and monitoring to the client.