During a routine dressing change,the nurse notes a vesicular rash across the abdomen of a client who is 2 days postop after hysterectomy.The client's a.m.meds,including modafinil (Provigil),ibuprofen,and a multivitamin with iron,are due in 30 minutes.What nursing action is essential?

Question

Quizplus · Accepted Answer

Holding the modafinil is the essential nursing action because modafinil is a medication which can cause a severe and potentially fatal skin reaction called Stevens-Johnson syndrome. The presence of a vesicular rash indicates the possibility of a severe skin reaction, thus it is essential to hold the modafinil and consult with the healthcare provider about the rash. Furthermore, it would also be appropriate to assess the client for other signs and symptoms of Stevens-Johnson syndrome such as fever, malaise, and mucosal involvement, and to document the findings in detail. It is not necessary to culture the drainage from the rash since the primary concern is preventing a life-threatening reaction. Administering the medications and showing the rash to the healthcare provider on rounds later in the day are not appropriate actions since modafinil needs to be held due to the possibility of Stevens-Johnson syndrome. Holding ibuprofen to check the client's medical record for drug allergies is not relevant since the main concern is identifying the cause of the rash and ruling out Stevens-Johnson syndrome.

During a Routine Dressing Change,the Nurse Notes a Vesicular Rash