A nurse is discussing the administration of an intravenous infusion of rituximab (Rituxan) with a nursing student. Which statement by the student indicates a need for further education about the care of a patient receiving this drug?
A) "Angioedema and hypersensitivity may occur, but they are usually self-limiting and mild."B) "I should be prepared to administer epinephrine, glucocorticoids, and oxygen if needed."C) "I will administer an antihistamine and acetaminophen before beginning the infusion."D) "I will monitor this patient's blood pressure, respiratory rate, and oxygen saturation closely."

A) "Angioedema and hypersensitivity may occur, but they are usually self-limiting and mild.

Explanation:

Rituximab is a monoclonal antibody which is given to people suffering from autoimmune diseases. It destroys B cells to reduce the attack on patient's body by their own immune system.

It can cause many side effects and angioedema and hypersensitivity are one of them. These side effects are potentially fatal and if observed are a matter of concern. They are caused due to cytokine release syndrome which is a result of rituximab therapy.

When the B cells are destroyed they release cytokines and along with them other immune cells also release cytokines. Cytokines are signalling molecules which further activate more immune cells. Due to production of too many cytokines, angioedema and hypersensitivity can occur which are characterized by swelling, rash, fever, headache etc. Heart beat can become rapid and blood pressure can drop dangerously. It can also result in seizures. Hence, these side effects are not mild and self limiting.

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