A nurse is collecting data from a client who has pyelonephritis and receiving gentamicin via IV infusion. Which of the following manifestation should the nurse identify as an adverse effect of the treatment?

A) "It takes 2 months of scheduled use before this medication is effective.":
This statement is incorrect. Montelukast is a leukotriene receptor antagonist that works to prevent asthma symptoms and improve lung function. It typically takes a few days to a week for the medication to become effective, not 2 months. Immediate relief is not expected, but long-term benefits can be seen within a relatively short period after starting the medication.

B) "I will give this medication to my child every 2 hours if he is wheezing.":
This statement is incorrect. Montelukast is a maintenance medication that is taken on a daily basis to prevent asthma symptoms. It is not a rescue medication and should not be used every 2 hours when the child is wheezing. Rescue medications like short-acting beta-agonists (e.g., albuterol) should be used during an asthma attack or when wheezing occurs.

C) "I will give this medication to my child once daily in the evening.":
This statement is correct. Montelukast is typically taken once daily in the evening. It helps to reduce inflammation and prevent asthma symptoms, and taking it in the evening aligns with the medication's intended use for long-term control of asthma.

D) "I can stop giving my child this medication if he is taking steroids.":
This statement is incorrect. Montelukast is often used alongside steroids (inhaled corticosteroids) for managing asthma. The two medications work in different ways, and discontinuing montelukast while continuing steroids may not provide optimal asthma control. It is important to follow the healthcare provider's instructions regarding the use of both medications.

A) Patient care technician: While a patient care technician (PCT) is an important part of the healthcare team, their role generally focuses on providing direct patient care tasks such as monitoring vital signs, assisting with activities of daily living, and supporting the nursing staff. They do not have the expertise to address complex medication interactions, so they are not the appropriate referral in this scenario.

B) Psychologist: A psychologist focuses on providing mental health support, including therapy and counseling. While medication interactions may be of concern in patients receiving psychiatric medications, a psychologist does not typically have the medical knowledge to assess or manage pharmacological interactions. The nurse would not make a referral to a psychologist for this issue.

C) Social worker: Social workers are important for addressing the social and emotional needs of patients, including helping with care coordination, support, and resources. However, they are not trained to evaluate or address medication interactions. This issue would be outside of their scope of practice.

D) Advanced practice nurse: An advanced practice nurse (APN), such as a nurse practitioner or clinical nurse specialist, has advanced training in diagnosing, managing, and prescribing medications. They are the most appropriate team member to assess the potential interactions of the client’s medications and make any necessary adjustments to their medication regimen. The nurse should refer the client to an APN for expertise in this area.