A nurse is reinforcing teaching with a client who is taking allopurinol about the risk for developing Stevens-Johnson syndrome.
For which of the following manifestations should the nurse instruct the client to monitor and report?
A.
Tinnitus with ear pain
B.
Hyperreflexia
C.
Skin rash with fever
D.
Diplopia
The Correct Answer and Explanation is:
The correct answer is C. Skin rash with fever.
Explanation:
Allopurinol is a medication commonly used to lower uric acid levels in conditions such as gout or certain types of kidney stones. It is essential to monitor patients taking allopurinol for potential adverse effects, including serious skin reactions such as Stevens-Johnson syndrome (SJS). Stevens-Johnson syndrome is a rare but severe condition characterized by a widespread rash, fever, and mucosal involvement.
Manifestations of Stevens-Johnson Syndrome:
- Skin Rash with Fever:
- Skin Rash: Typically, SJS presents as a painful, red or purple rash that spreads rapidly. The rash often evolves into blisters and can cover large areas of the body. This rash is a key symptom to monitor for as it is one of the primary indicators of SJS.
- Fever: A fever often accompanies the rash and is indicative of systemic involvement. The presence of both a fever and a rash, especially if it develops suddenly, should be a significant concern.
- Other Symptoms:
- Tinnitus with Ear Pain (Option A): While tinnitus and ear pain are possible side effects of various medications, they are not specifically associated with Stevens-Johnson syndrome. These symptoms might suggest other issues but are not the primary indicators for SJS.
- Hyperreflexia (Option B): This refers to overactive reflexes and is not a recognized symptom of Stevens-Johnson syndrome. It might indicate a different neurological condition or medication side effect.
- Diplopia (Option D): Diplopia, or double vision, is not a symptom of Stevens-Johnson syndrome. It is more commonly associated with neurological disorders or eye issues.
Importance of Early Detection: Early detection and prompt reporting of skin rash and fever are crucial in preventing the progression of Stevens-Johnson syndrome. The condition can escalate quickly and may lead to severe complications if not addressed immediately. Therefore, patients on allopurinol should be instructed to report these symptoms to their healthcare provider without delay to ensure timely intervention and appropriate management.
In summary, the nurse should instruct the client to monitor and report skin rash with fever as these symptoms are indicative of Stevens-Johnson syndrome, a serious and potentially life-threatening condition that requires immediate medical attention.