A nurse is administering erythromycin eye ointment to a newborn who has a history of allergic reaction to penicillin.

What should the nurse do before applying the ointment?

The correct answer is choice B. Lactic acidosis.

Lamivudine (Epivir) is a nucleoside reverse transcriptase inhibitor (NRTI) used to treat chronic hepatitis B infection and HIV infection.

One of the rare but serious adverse effects of lamivudine is lactic acidosis, which is a condition where the blood becomes too acidic due to the accumulation of lactate.Lactic acidosis can cause symptoms such as nausea, vomiting, abdominal pain, muscle weakness, rapid breathing, and low blood pressure.

Choice A is wrong because pancreatitis is not a common side effect of lamivudine.

Pancreatitis is an inflammation of the pancreas that can cause severe abdominal pain, nausea, vomiting, and fever.Pancreatitis is more likely to occur with other NRTIs such as didanosine (Videx) or stavudine (Zerit).

Choice C is wrong because hypothyroidism is not a common side effect of lamivudine.

Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels of the body.

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression.

Hypothyroidism is more likely to occur with other drugs that interfere with thyroid function such as amiodarone (Cordarone) or lithium

The correct answer is choice B. Check if there is any cross-sensitivity between erythromycin and penicillin.Erythromycin is a macrolide antibiotic that can be used to treat bacterial eye infections in newborns and adults.

Penicillin is a beta-lactam antibiotic that can cause allergic reactions in some people.

Cross-sensitivity means that a person who is allergic to one type of antibiotic may also be allergic to another type of antibiotic that has a similar structure or mechanism of action.Erythromycin and penicillin have different structures and mechanisms of action, but there is still a small chance of cross-sensitivity between them.

Therefore, the nurse should check if the newborn has any history of allergic reaction to penicillin before applying the erythromycin eye ointment.

Choice A is wrong because asking the mother if she has any allergies to antibiotics is not enough to determine if the newborn is at risk of an allergic reaction to erythromycin.

The newborn may have inherited or developed an allergy to penicillin or erythromycin that the mother does not have.

Choice C is wrong because applying a small amount of ointment on the skin to test for allergic reaction is not a reliable method to diagnose an allergy.Skin testing can cause false positive or false negative results, and it may also trigger a severe allergic reaction in some cases.

Choice D is wrong because administering an antihistamine to prevent anaphylaxis is not appropriate for a newborn who has not been exposed to the allergen yet.

An antihistamine is a medication that blocks the effects of histamine, a chemical that causes allergic symptoms.

Anaphylaxis is a life-threatening allergic reaction that involves multiple organ systems and requires immediate medical attention.An antihistamine cannot prevent anaphylaxis, and it may also cause side effects such as drowsiness, dry mouth, or low blood pressure in a newborn.