When patients are treated with rasburicase, specific
nursing precautions should be taken. The blood samples
for measurement of uric acid levels must be placed on ice
immediately until the completion of assays (preferably
within 4 hours of collection). This cooling procedure is
necessary because rasburicase at room temperature can
maintain its activity in blood samples ex vivo, which
causes the breakdown of uric acid, and may result in false
readings of low uric acid values (Coiffier et al., 2008).
Carefully documenting the patient’s past medical history
is crucial, as rasburicase is contraindicated in patients
with a known glucose-6-phosphate dehydrogenase
(G6PD) deficiency, and in patients with a known history
of anaphylaxis or hypersensitivity reactions (Cairo &
Bishop, 2004; Coiffier et al., 2008). It is vital for pediatric
oncology nurses to know and recognize the signs of
hypersensitivity reactions. Stop the infusion of rasburicase
when the first sign of hypersensitivity reaction
occurs. It is also essential for pediatric oncology nurses to
obtain the vital signs, and to assess and maintain the
patient’s airway, breathing, and circulation (HeldWarmkessel,
2010).