A nurse is assessing a client who has a prescription for cefaclor. Which of the following findings should the nurse recognize as an indication of an allergic reaction?
Hematuria
Pruritus
Slurred speech
Tremor
The Correct Answer is B
A) Hematuria: Hematuria, or blood in the urine, is not typically associated with an allergic reaction to cefaclor. Instead, it may indicate other conditions such as urinary tract infection, kidney stones, or trauma to the urinary tract. While allergic reactions can affect the urinary system, hematuria is not a common manifestation.
B) Pruritus: Pruritus, or itching, is a classic symptom of an allergic reaction to medications, including antibiotics like cefaclor. Itching may occur on the skin or mucous membranes and can range from mild to severe. It is often accompanied by other allergic symptoms such as rash, hives, or swelling. Therefore, the presence of pruritus should alert the nurse to a potential allergic reaction to cefaclor.
C) Slurred speech: Slurred speech is not a typical manifestation of an allergic reaction to cefaclor. It is more commonly associated with neurological conditions, intoxication, stroke, or side effects of certain medications, rather than an allergic response to antibiotics.
D) Tremor: Tremor, or involuntary shaking, is not a characteristic sign of an allergic reaction to cefaclor. Tremors can have various causes, including neurological disorders, medication side effects, or metabolic abnormalities. While tremors can occur in severe allergic reactions (anaphylaxis), they are not among the primary symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Elevate the extremity: This action helps reduce swelling and minimizes the spread of infiltrated fluid into surrounding tissues by using gravity to assist in draining the excess fluid back into the bloodstream. Elevating the affected limb above the level of the heart promotes venous return and can help prevent further tissue damage.
B) Flush the IV catheter: Flushing the IV catheter could exacerbate infiltration by pushing more fluid into the surrounding tissue. It is not the appropriate action for managing infiltration and could worsen the client's condition.
C) Slow the infusion rate: Slowing the infusion rate is a reasonable action to reduce the flow of fluid into the tissues and minimize further infiltration. However, it may not be sufficient to manage existing infiltration effectively or prevent tissue damage.
D) Apply pressure to the IV site: Applying pressure to the IV site is not recommended for managing infiltration. It could cause further tissue damage and discomfort for the client and is not considered a standard practice in managing this complication.
Correct Answer is C
Explanation
A) Monitor the client for seizure activity: While diazepam is an anticonvulsant medication and may be used to prevent or treat seizures, it is unlikely to cause seizure activity as an adverse reaction when administered for moderate sedation. However, if the client has a history of seizures or is at risk for seizures, monitoring for seizure activity is essential. In the context of moderate sedation, the primary concern is related to the sedative effects of diazepam rather than seizure activity.
B) Check the client's urinary output: Monitoring urinary out’ut is important for assessing renal function and fluid balance, but it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve central nervous system depression, respiratory depression, or cardiovascular effects. Monitoring urinary output may be part of routine nursing care but is not specific to assessing adverse reactions to diazepam.
C) Monitor the client's oxygen saturation: This is the correct’action. Monitoring the client's oxygen saturation is essential for det’cting adverse reactions to diazepam, such as respiratory depression or hypoventilation. Diazepam can cause respiratory depression, especially when administered in higher doses or in combination with other sedative medications. Monitoring oxygen saturation allows the nurse to detect any signs of hypoxemia early and intervene promptly to ensure adequate oxygenation.
D) Auscultate the client's bowel sounds: While assessing bowel so’nds is important for evaluating gastrointestinal function, it is not directly related to assessing adverse reactions to diazepam. Adverse reactions to diazepam typically involve effects on the central nervous system and respiratory system rather than gastrointestinal function. Monitoring bowel sounds may be part of routine nursing assessment but is not specific to assessing adverse reactions to diazepam.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
