A nurse is planning care for a male client who is postoperative following a hernia repair. Which of the following actions should the nurse include in the plan?

Rationale:
A. Call the pharmacist for clarification of the medication contraindications: While the pharmacist can provide medication information, it is the provider’s responsibility to evaluate the appropriateness of the prescription and modify it if needed.

B. Administer the medication as prescribed: Administering amoxicillin to a client allergic to penicillin places the client at risk for an allergic reaction, including anaphylaxis, since both drugs are in the same class.

C. Discuss the prescription with the health care provider: Amoxicillin is a penicillin derivative and contraindicated for clients with penicillin allergies. The nurse should immediately clarify the prescription with the provider before administration to ensure client safety.

D. Place an incident report in the medical record: Incident reports are used after an error or near-miss has occurred, not before a potential error is prevented. They are also never placed in the client’s medical record.

Rationale:
A. The nurse positions a client who is postoperative in a semi-Fowler's position: Semi-Fowler’s promotes lung expansion and comfort postoperatively, especially after abdominal or thoracic surgery, making this an appropriate nursing action.

B. The nurse uses clean gloves when administering an enema: Clean gloves are sufficient for enema administration since it is a clean (not sterile) procedure, and this reflects correct practice.

C. The nurse performs auscultation of the lungs without lifting the gown: Clothing or gowns interfere with accurate transmission of breath sounds, leading to possible misinterpretation. The gown should be lifted or moved aside to properly auscultate.

D. The nurse applies a cold compress to reduce localized swelling: Cold therapy decreases blood flow and inflammation, making this an appropriate intervention for localized swelling or injury.