A nurse in a long-term care facility is managing the care of an older adult client who has difficulty swallowing and occasional choking during meals. The nurse should initiate a referral to which of the following members of the interprofessional care team?

Rationale:

A. Check the compatibility of cefazolin with the client's existing IV fluids: Compatibility is important to prevent precipitation or inactivation of the drug, but it should be done only after confirming the medication is safe for the client to receive.

B. Assess the IV for patency: Ensuring the IV line is patent is necessary before administration to avoid infiltration or extravasation, but it is not the first priority when preparing a first-time antibiotic dose.

C. Review the client's allergy history: Reviewing allergies is the first and most critical step, as cefazolin is a cephalosporin that can cause severe allergic reactions, particularly in clients with a history of beta-lactam (e.g., penicillin) allergy. Administering the drug without this check could cause life-threatening anaphylaxis.

D. Obtain the reconstituted antibiotic from the pharmacy: Securing the medication from the pharmacy is part of preparation, but this should only occur after confirming it is safe for the client to receive based on allergy status.

Rationale:

A. Tetracycline 200 mg PO: This prescription is incomplete because it does not specify the frequency or duration of administration, making it unclear how the medication should be given safely.

B. Cimetidine PO twice daily: The prescription lacks the dosage strength in milligrams, which is essential for accurate administration and safe dosing.

C. Digoxin 0.25 mg PO daily: This prescription includes the medication name, dosage, route, and frequency, providing all essential components needed for safe administration.

D. Epoetin alfa 150 units/kg three times weekly: While it includes dose and frequency, it does not specify the route (subcutaneous or IV), which is required to complete the prescription safely.