A nurse is caring for a child who has a penicillin allergy.
Which of the following prescriptions should the nurse verify with the provider?

Choice A rationale:

Rifampin is an antibiotic used to treat or prevent tuberculosis (TB). However, the treatment with this medication typically lasts longer than one month. In fact, TB treatment usually involves taking several drugs for a long time.

Choice B rationale:

While it’s important to take some medications with meals to increase absorption or decrease stomach upset, rifampin should be taken at least 1 hour before or 2 hours after a meal. This helps to ensure optimal absorption of the medication.

Choice C rationale:

Insomnia is not typically listed as a common side effect of rifampin. The medication can cause a number of side effects, but these more commonly include things like upset stomach, loss of appetite, nausea, vomiting, diarrhea, and changes in behavior.

Choice D rationale:

One of the known side effects of rifampin is that it can cause a red-orange discoloration of body fluids, including urine, sweat, saliva, and tears. This can be alarming to patients if they are not forewarned, so it’s important for the nurse to provide this information during discharge instructions.

Choice A rationale:

Shaking the insulin vial vigorously is not recommended. It can lead to the formation of bubbles, which can affect the accuracy of the dose. Instead, insulin vials should be gently rolled between the hands to mix.

Choice B rationale:

Injecting insulin into the abdominal area is indeed a recommended practice. The abdomen is a preferred site for insulin injection because it has a faster absorption rate compared to other areas. This can help to more effectively regulate blood glucose levels.

Choice C rationale:

Exercise typically lowers blood glucose levels, so insulin doses may need to be reduced to prevent hypoglycemia. Clients should monitor their blood glucose closely and adjust insulin as directed by their healthcare provider.

Choice D rationale:

Freezing unopened insulin vials is not advised. Freezing can disrupt the insulin structure, rendering it ineffective. Insulin should be stored in a refrigerator at a temperature between 2°C and 8°C (36°F and 46°F). Once opened, it can be kept at room temperature for up to 28 days.