A nurse is caring for a client who has heart failure and is taking hydrochlorothiazide. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication?

A. Assess the client for adverse reactions:
After ensuring the client's safety and well-being, the nurse can then proceed with the other necessary actions, such as determining the factors that led to the omission, filing an incident report, and reporting the missed dosage to the client's provider. However, assessing the client for any immediate adverse reactions takes precedence to address any potential harm that may have resulted from the missed medication dose.
B. Determine factors that led to the omission:
This is the correct answer. Understanding the factors that led to the omission is crucial for preventing future errors. The nurse should assess if there were any system failures, distractions, or other factors contributing to the missed dose.However, patient's safety and wellbeing comes first.
C. File an Incident report:
Filing an incident report is an important step, but it should not be the first action. The nurse needs to address the immediate situation and assess the factors contributing to the omission first.
D. Report the missed dosage to the client's provider:
Reporting the missed dosage to the provider is an important step, but it should not be the first action. The nurse needs to address the immediate situation, assess the client, and determine factors leading to the omission before reporting to the provider.

A. Obtain a prescription for an alternative antibiotic:
Clindamycin is generally safe for penicillin-allergic clients there is no need for an alternative antibiotic.
B. Administer the clindamycin using a desensitization schedule:
Using a desensitization schedule is a specialized procedure typically reserved for certain situations and performed in a controlled environment. It is not a standard approach for administering antibiotics, and in this case, obtaining an alternative antibiotic is a more appropriate and straightforward solution.
C. Premedicate the client with epinephrine before administering the antibiotic:
Premedicating with epinephrine is not a routine practice for preventing allergic reactions to antibiotics. While epinephrine may be used in severe allergic reactions, it's not a preemptive measure in this context. It's important to address the underlying issue by avoiding the allergen (penicillin class) and using an alternative antibiotic.
D. Give the client the prescribed dose of the clindamycin:
Clindamycin is generally safe for penicillin-allergic clients since it belongs to the lincosamide class and does not share the beta-lactam ring structure responsible for allergic reactions to penicillins.