A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following manifestations indicate to the nurse that the client has developed a systemic anticholinergic effect?

A.Cephalexin oral suspension should typically be stored in the refrigerator to maintain its stability and effectiveness. Storing it at room temperature could affect its potency.

B.Shaking the oral suspension is necessary to ensure the medication is evenly distributed before each dose, providing the client with the correct dosage of active ingredients. Failure to shake the suspension can result in uneven dosing.

C.Cephalexin is a cephalosporin antibiotic, and there is a potential for cross-sensitivity in clients who are allergic to penicillin. Up to 10% of people with a penicillin allergy may also be allergic to cephalosporins. Checking for a penicillin allergy helps prevent an adverse reaction, making it a critical safety measure before administering cephalexin.

D.While some antibiotics can cause gastrointestinal side effects, constipation is not a common adverse effect associated with cephalexin. The nurse should instead monitor for other side effects like diarrhea, which is more typical with antibiotics and can indicate a mild side effect or a more severe condition, such as Clostridioides difficile infection.

The correct answer is choicec. Administer the medication under the client’s tongue.

Choice A rationale:

Administering the crushed medication through the NG tube is inappropriate because sublingual medications are designed to be absorbed through the tissues under the tongue, not the gastrointestinal tract. Crushing and administering it through the NG tube would alter its intended absorption and effectiveness.

Choice B rationale:

Dissolving the medication in water and giving it through the NG tube is also incorrect for the same reasons as Choice A. Sublingual medications are specifically formulated to be absorbed through the mucous membranes under the tongue, and changing the route of administration can affect the drug’s efficacy.

Choice C rationale:

Administering the medication under the client’s tongue is the correct action. Sublingual medications are designed to be absorbed directly into the bloodstream through the tissues under the tongue, bypassing the digestive system and providing rapid onset of action.

Choice D rationale:

While some medications can be safely switched to oral formulations for NG tube administration, such a change is only necessary when the prescribed route (in this case, sublingual) cannot be used. Without contraindications (e.g., inability to hold the medication under the tongue or mucosal issues), the original sublingual route should be followed.