A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?
Contact the healthcare provider.
Give with prescribed antihistamine.
Administer the medication as prescribed.
Monitor the client for a rash or hives.
The Correct Answer is A
Choice A Reason:
Contact the healthcare provider: Given the client’s history of anaphylactic reaction to penicillin, there is a potential risk of cross-reactivity with cephalexin, a cephalosporin. Although the risk of cross-reactivity is relatively low, it is still significant enough to warrant caution. Studies indicate that 1-4% of people with a true penicillin allergy may also react to cephalosporins. Therefore, the nurse should contact the healthcare provider to discuss alternative antibiotics or additional precautions.
Choice B Reason:
Give with prescribed antihistamine: While antihistamines can help manage mild allergic reactions, they are not sufficient to prevent or treat anaphylaxis. Anaphylactic reactions require immediate medical intervention, including epinephrine administration. Therefore, relying solely on antihistamines is not an appropriate or safe action in this scenario.
Choice C Reason:
Administer the medication as prescribed: Administering cephalexin without consulting the healthcare provider could put the client at risk of a severe allergic reaction. Given the client’s history of anaphylaxis to penicillin, it is crucial to verify the safety of cephalexin with the healthcare provider before administration.
Choice D Reason:
Monitor the client for a rash or hives: While monitoring for allergic reactions is essential, it should not be the primary action in this case. The priority is to prevent a potential severe allergic reaction by consulting the healthcare provider before administering the medication. Monitoring alone does not address the underlying risk of cross-reactivity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Insulin glargine is a long-acting insulin used to manage blood glucose levels in patients with diabetes. It is not typically used for the acute management of severe hypoglycemia. Instead, fast-acting glucose sources or glucagon injections are recommended for severe hypoglycemia. Therefore, teaching the family how to inject insulin glargine for severe hypoglycemia is not appropriate.
Choice B reason: Teaching the client self-injection skills for daily subcutaneous administration is crucial. Insulin glargine is administered once daily to provide a steady level of insulin throughout the day and night. Proper self-injection technique ensures that the medication is delivered correctly and effectively, which is essential for managing blood glucose levels in type 2 diabetes.
Choice C reason: While it is important for patients to monitor their blood sugar levels, insulin glargine dosing is typically fixed and not adjusted based on before-meal blood sugar readings. Instead, adjustments to the dose are made based on overall blood glucose trends and A1C levels, under the guidance of a healthcare provider.
Choice D reason: Increasing the dosage of insulin glargine in response to ketoacidosis is not appropriate. Diabetic ketoacidosis (DKA) is a medical emergency that requires immediate treatment with rapid-acting insulin, fluids, and electrolytes. Patients should be instructed to seek emergency medical care if they experience symptoms of DKA.
Correct Answer is D
Explanation
Choice A reason:
Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.
Choice B reason:
Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.
Choice C reason:
Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.
Choice D reason:
Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.
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