A nurse is assisting in the care of a child who is receiving IV cefuroxime when the child begins to have difficulty breathing. Which of the following actions should the nurse take first?

Choice A reason:

Ibuprofen - Ibuprofen belongs to the nonsteroidal anti-inflammatory drugs (NSAIDs) class, which includes aspirin. Since the client reports an allergy to aspirin, there is a risk of cross- reactivity, leading to a potential allergic reaction. Therefore, Ibuprofen should be avoided.

Choice B reason:

Acetaminophen - Acetaminophen is not an NSAID, and it works differently from aspirin. It is a safe option for the client in the postpartum period to manage pain without causing a cross- reaction with their aspirin allergy. Acetaminophen primarily acts on the central nervous system to reduce pain and fever, making it suitable for the client.

Choice C reason:

Naproxen - Naproxen is also an NSAID, and like Ibuprofen, it carries the risk of cross-reactivity in someone allergic to aspirin. Therefore, Naproxen should be avoided in this client.

Choice D reason:

Celecoxib - Celecoxib is a type of NSAID known as a selective cyclooxygenase-2 (COX-2) inhibitor. Although it is a bit more selective and generally considered to have a lower risk of causing cross-reactions, it is still an NSAID and not recommended for someone with a known aspirin allergy. Hence, Celecoxib should not be administered to the client in this scenario.

Choice A reason:

The nurse should not reinforce to the client that they should not breastfeed after delivery. Group B streptococcus (GBS) is not transmitted through breast milk. It is crucial for infants born to GBS-positive mothers to receive appropriate prophylaxis, but breastfeeding is not contraindicated.

Choice B reason:

The nurse should maintain contact precautions for the client. Group B streptococcus is a highly contagious bacterium, and taking precautions can help prevent its transmission to other patients and healthcare workers.

Choice C reason:

The nurse does not need to obtain a pharyngeal culture from the client. Group B streptococcus colonization typically occurs in the genital and gastrointestinal tracts, not in the pharynx. Therefore, a pharyngeal culture would not be relevant in this situation.

Choice D reason:

This is the correct action the nurse should take. The client tested positive for group B streptococcus, which puts the newborn at risk of infection during labor and delivery. The standard protocol is to administer intravenous antibiotic prophylaxis to the mother during labor to reduce the risk of transmission to the baby.