A nurse in an urgent care clinic is collecting data from a client who reports having diarrhea for the past 3 days. Which of the following findings indicates hypokalemia?

Rationale:

A. Constipation: Constipation is not a common adverse effect of cefazolin. While gastrointestinal disturbances such as diarrhea or nausea can occur with antibiotics, constipation is typically unrelated and does not require immediate reporting.

B. Elevated skin patches: Skin eruptions, including hives or elevated erythematous patches, may indicate an allergic reaction to cefazolin. Early recognition and reporting are critical to prevent progression to severe hypersensitivity reactions such as anaphylaxis.

C. Ringing in the ears: Ototoxicity is more commonly associated with aminoglycoside antibiotics, not cefazolin, which is a cephalosporin. Tinnitus would not be an expected adverse effect requiring urgent reporting in this context.

D. Depression: Cefazolin is not linked to mood changes or psychiatric effects. Monitoring for depression is unnecessary in this case, as it is unrelated to the medication’s known adverse effects.

Answer: D

Rationale:

A) Collect 2 mL of sputum in an emesis basin: Collecting sputum in an emesis basin is inappropriate for laboratory testing. The sputum should be collected directly into a sterile container to prevent contamination. This ensures that the culture and sensitivity results are accurate and reflect the client's true respiratory pathogens.

B) Instruct the client to rinse with an antiseptic mouthwash prior to specimen collection: Using an antiseptic mouthwash before collecting a sputum sample is not recommended because it may alter the flora present in the sputum, leading to inaccurate culture results. Instead, the client should rinse their mouth with plain water to clear excess saliva or food debris.

C) Swab the oropharynx with a sterile swab: Swabbing the oropharynx does not obtain sputum from the lungs but instead gathers a sample from the throat, which may not be reflective of lower respiratory infections. A proper sputum sample is produced through a deep cough to collect material directly from the lungs.

D) Refrigerate the specimen until the time of transport to the laboratory: Refrigerating the sputum specimen helps to preserve its integrity by preventing the overgrowth of bacteria or other pathogens until it can be transported to the laboratory. Proper refrigeration ensures that the culture and sensitivity results remain accurate.