A nurse in the emergency department is planning care for a client who had a myocardial infarction and is receiving thrombolytic therapy with an WV infusion of alteplase. Which of the following interventions should the nurse include in the plan?

The nurse should plan to take the following actions:

A.Verify the prescription: Before administering any medication, the nurse must verify the prescription to ensure accuracy, appropriateness, and that it matches the provider's order.

Regarding option B, administering the medication at 1000, 1400, 1800, and 2200 may not be appropriate. The prescription states that ampicillin should be administered every 6 hours. The nurse should administer the medication at equally spaced intervals throughout the day. If the medication is prescribed every 6 hours, the appropriate administration times would be 0600, 1200, 1800, and 2400. However, the question does not provide sufficient information to determine the exact administration times, so option B cannot be definitively selected.

C. Assess the client for an allergy to penicillin: Since ampicillin is a penicillin-class antibiotic, it is essential for the nurse to assess the client for any history of allergies to penicillin or other beta-lactam antibiotics. A penicillin allergy could lead to a severe allergic reaction, so it is crucial to identify any potential allergies before administering the medication.

D. Document giving the medications: After administering the ampicillin, the nurse should document the administration in the client's medical record, including the time, dose, route, and any relevant observations or assessments.

E. Obtain a sputum for culture and sensitivity: The client's new prescription for ampicillin may be related to an infection. To ensure appropriate and effective treatment, obtaining a sputum specimen for culture and sensitivity is necessary. This will help identify the specific bacteria causing the respiratory infection and determine which antibiotics will be most effective in treating it.

The nurse should report to the provider that the client is taking ginkgo biloba. Ginkgo biloba is an herbal supplement that can interact with clopidogrel and other antiplatelet medications. It may increase the risk of bleeding when taken concurrently with clopidogrel, which is an antiplatelet medication used to prevent blood clots after coronary artery stenting.

Let's go through the other options:

A. The client is taking acetaminophen: Acetaminophen is not known to have significant interactions with clopidogrel. It is a commonly used pain reliever and fever reducer and does not usually affect the antiplatelet activity of clopidogrel.

B. The client is taking valerian: Valerian is an herbal supplement often used as a sleep aid or to reduce anxiety. While there is limited evidence of significant interactions with clopidogrel, it is generally recommended to use caution when combining valerian with antiplatelet medications. However, it is not as concerning as ginkgo biloba in terms of potential bleeding risk.

C. The client is taking vitamin B6: Vitamin B6 is a water-soluble vitamin and is not expected to have significant interactions with clopidogrel. It is generally considered safe to use vitamin B6 with antiplatelet medications like clopidogrel.