A nurse is preparing to administer ampicillin/sulbactam 15 g via intermittent IV bolus, Available is ampicillin-sulbactam 1.5 g in 0.9% sodium chloride 100 mL to infuse over 30 min. The nurse should set the IV infusion pump to deliver how many mL/h?
(Round the answer to the nearest whole number. Use a leading zero if it applies in not use a trailing zero)

The nurse should report a creatinine level of 2 mg/dl to the provider as a potential adverse effect of captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat congestive heart failure and hypertension. One of the side effects of ACE inhibitors, including captopril, is the potential to cause kidney problems, leading to an increase in serum creatinine levels.

An increase in serum creatinine may indicate impaired kidney function, and it is essential to monitor kidney function regularly in clients taking ACE inhibitors. Elevated creatinine levels can suggest reduced glomerular filtration rate (GFR) and impaired kidney function, which may require adjustments in medication dosage or further evaluation and management.

Let's go through the other options:

A. Absolute neutrophil count (ANC) 4.000/ mm^3: An absolute neutrophil count of 4.000/ mm^3 is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

B. Brain natriuretic peptide (BNP) 90 ng/L: A brain natriuretic peptide (BNP) level of 90 ng/L is used to assess heart failure severity. While BNP levels can be helpful in managing congestive heart failure, a BNP level of 90 ng/L is not an adverse effect of captopril that requires immediate reporting.

C. Sodium 140 mEq/l: A sodium level of 140 mEq/L is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

When a medication error occurs, the nurse should report the incident to the nurse manager or appropriate supervisor. It is essential to follow the facility's policies and procedures for reporting and managing medication errors. Prompt reporting allows for appropriate investigation, documentation, and implementation of necessary measures to prevent future errors.

Documenting that the pharmacy sent the incorrect medication (B) is not appropriate in this situation, as it does not address the nurse's role and responsibility in the error. Reporting the incident is the primary action required.

Contacting the provider to change the client's prescription (C) is not necessary in this case, as the error was related to the medication selection during administration, not an issue with the prescription itself.

Placing the unwrapped celecoxib back into the AMDS (D) is not appropriate. Once a medication has been removed from its packaging or container, it should not be returned to the dispensing system. Additionally, since it was the wrong medication for the client, it should not be administered.

Therefore, the nurse should primarily report the incident to the nurse manager or appropriate supervisor to ensure appropriate handling of the medication error.