A nurse is caring for a 45-year-old male client in the emergency department who reports severe abdominal pain.

Exhibits

Based on the information provided, which of the following provider’s prescriptions are anticipated, nonessential, or contraindicated for the client? Select one response per row.

•    Increase fiber intake: This is nonessential at this time. While a high-fiber diet can help prevent future episodes of diverticulitis, it won’t help in the acute phase, especially when the client is unable to eat or drink without vomiting.
•    CT of the abdomen with contrast: This is an anticipated action. A CT scan can help confirm the diagnosis of diverticulitis and assess the severity of the condition.
•    Flexible sigmoidoscopy: This is an anticipated action. A flexible sigmoidoscopy can help visualize the diverticula and assess the extent of the inflammation.
 

•    Change IV fluids to 0.9% sodium chloride with KCl: This is an anticipated action. The client is likely dehydrated due to vomiting and unable to take oral fluids, so IV hydration is necessary. The client’s potassium level is at the lower end of the normal range, so adding KCl to the IV fluids can help prevent hypokalemia.
•    Type and crossmatch blood: This is an anticipated action. The client has a positive stool occult blood test and a lower than normal hemoglobin and hematocrit, suggesting that he may be experiencing bleeding. It’s important to have blood ready for a transfusion if necessary.
•    Administer IV piperacillin-tazobactam: This is contraindicated. Piperacillin-tazobactam is a penicillin-based antibiotic, and the client has a known allergy to penicillin. Another class of antibiotics should be used. Please note that these are potential actions and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.