A nurse is caring for a client who just received a dose of IV ampicillin. Which of the following client reactions requires priority intervention by the nurse?

A. By assessing the temperature every 4 hours:

Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.

B. By repeating a culture and sensitivity test on day 3:

Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.

C. By obtaining drug peak and trough levels:

This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.

D. By assessing for breathlessness:

Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.

A. “I cannot smoke while taking this medication."

This statement is not directly related to the proper use of clarithromycin (Biaxin). While smoking cessation is generally encouraged for overall health, it is not specifically required while taking clarithromycin. However, smoking may affect the effectiveness of antibiotics in general due to its impact on the respiratory system and immune function.

B. “I can quit taking this medication when I feel better."

This statement is incorrect. It is important to emphasize to the client that they should complete the full course of antibiotics as prescribed by their healthcare provider, even if they start to feel better before finishing the medication. Stopping the medication prematurely can lead to incomplete treatment and potentially contribute to antibiotic resistance.

C. “I cannot drive while taking this medication.”

This statement is not accurate. Clarithromycin (Biaxin) is not typically associated with sedation or impairment of driving ability. While some medications may cause drowsiness or other side effects that affect driving, this is not a common side effect of clarithromycin.

D. “I need to take this medication until it is gone."

This statement indicates an understanding of the importance of completing the full course of antibiotics as prescribed by the healthcare provider. Taking the medication until it is finished helps ensure that all bacteria are effectively treated and reduces the risk of antibiotic resistance.