The nurse reviews a follow-up note for a client who recently… | MyMerci
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Medication Administration

The nurse reviews a follow-up note for a client who recently started allopurinol. Which findings require immediate follow-up? Highlight the findings associated with a serious hypersensitivity reaction.

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Nurses' Notes 0910: The client began allopurinol 100 mg daily 8 days ago for recurrent gout. The client reports that a red rash began on the trunk and is spreading to both arms. The affected knee is less tender than it was at the previous visit. Yesterday's uric acid level was lower than the pretreatment value. At 0830, the client measured a temperature of 38.6 °C. The nurse observes new facial edema with fever and malaise. The client reports drinking water regularly unless otherwise instructed. During the interview, the client states that urine remains clear yellow without dysuria. The oral examination shows painful mouth erosions with burning eyes. The client had mild nausea for 10 minutes after breakfast yesterday. Medication reconciliation confirms the prescribed dose was taken once each morning. The client denies shortness of breath at rest. The right great toe has no warmth or new swelling today. The client asks whether the next refill can be synchronized with other medications. The nurse notes that the pharmacy label and daily instructions match the active prescription. No new injury was reported.
Nurses' Notes 0910: The client began allopurinol 100 mg daily 8 days ago for recurrent gout. The client reports that a red rash began on the trunk and is spreading to both arms. The affected knee is less tender than it was at the previous visit. Yesterday's uric acid level was lower than the pretreatment value. At 0830, the client measured a temperature of 38.6 °C. The nurse observes new facial edema with fever and malaise. The client reports drinking water regularly unless otherwise instructed. During the interview, the client states that urine remains clear yellow without dysuria. The oral examination shows painful mouth erosions with burning eyes. The client had mild nausea for 10 minutes after breakfast yesterday. Medication reconciliation confirms the prescribed dose was taken once each morning. The client denies shortness of breath at rest. The right great toe has no warmth or new swelling today. The client asks whether the next refill can be synchronized with other medications. The nurse notes that the pharmacy label and daily instructions match the active prescription. No new injury was reported.
Explanation
A spreading rash, fever with facial edema, and painful oral or eye involvement require immediate evaluation. These findings can signal severe allopurinol hypersensitivity rather than an expected gout flare.
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