A nurse is assisting with the care of a client on a medical surgical unit who was admitted from the emergency department.

Exhibits

For each assessment finding on Day 2 click to specify if the finding is due to lisinopril, carvedilol, or furosemide. Each finding may be related to more than 1 medication.

Anticipated:

• Pyrazinamide: This is a first-line anti-tuberculosis medication used in combination therapy to treat active TB. It helps shorten treatment duration and targets intracellular bacteria.
• Contact precautions: TB is transmitted via airborne droplets, requiring airborne precautions instead. However, contact precautions can still be implemented in addition to airborne precautions.
• Ethambutol: This medication is used to prevent resistance and is part of the standard four-drug regimen for active tuberculosis.
• Isoniazid: A core component of TB treatment, isoniazid is effective against actively dividing Mycobacterium tuberculosis. It is typically given for at least 6 months.
• Airborne precautions: TB is transmitted through airborne droplets, necessitating airborne precautions such as an N95 mask, negative-pressure isolation, and limiting client transport.
• Rifampin: Another first-line anti-tuberculosis drug, rifampin works by inhibiting bacterial RNA synthesis and is a crucial part of combination therapy for TB.

Contraindicated:

• Monthly TB skin test for 1 year: Once TB is confirmed via sputum culture and chest x-ray, repeated skin testing is unnecessary and would not provide additional diagnostic value.

A. Time. The prescription states that erythromycin should be administered four times per day, which is a standard frequency for this medication. No clarification is needed unless there are specific timing concerns, such as administration with or without food.
B. Medication. Erythromycin is a commonly prescribed macrolide antibiotic used for bacterial infections. Since the medication itself is clearly stated, there is no need to clarify this aspect of the prescription.
C. Route. The prescription does not specify the route of administration (e.g., oral, intravenous, or topical). Since erythromycin is available in multiple forms, including oral tablets, capsules, liquid suspension, and intravenous formulations, it is essential to clarify the intended route with the provider before administration.
D. Dosage. A dose of 500 mg four times per day is a typical dosage for erythromycin in treating infections. Unless there are concerns regarding the client’s renal or hepatic function or potential drug interactions, the dosage does not require clarification.