A nurse is preparing to administer clindamycin to a client who states she forgot to report to the provider that she is allergic to penicillin. Which of the following actions should the nurse take?
Give the client the prescribed dose of the clindamycin.
Obtain a prescription for an alternative antibiotic.
Premeditate the client with epinephrine before administering the antibiotic.
Administer the clindamycin using a desensitization schedule.
The Correct Answer is B
Choice A Reason:
Giving the prescribed dose of clindamycin is not appropriate due to the reported penicillin allergy, which increases the risk of an allergic reaction.
Choice B Reason:
Obtain a prescription for an alternative antibiotic is correct. Given the client's reported allergy to penicillin, which is in the same antibiotic class as clindamycin (both are antibiotics that belong to the beta-lactam group), there is a higher risk of cross-reactivity and potential allergic reaction. Therefore, it's important to avoid administering clindamycin in such cases and seek an alternative antibiotic that does not have a similar chemical structure to penicillin to prevent an allergic reaction.
Choice C Reason:
Premeditating the client with epinephrine before administering the antibiotic is not a standard practice in this context. Epinephrine is used to treat severe allergic reactions but is not used as a preventive measure before administering antibiotics.
Choice D Reason:
Administering the clindamycin using a desensitization schedule might be an option in certain situations under the guidance of an allergist or immunologist, but it's not typically performed by nurses and requires a specific protocol and expertise in managing drug allergies. Obtaining an alternative antibiotic is a more appropriate and immediate action to avoid the risk of an allergic reaction in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Hypokalemia is correct. Hydrochlorothiazide is a thiazide diuretic that promotes the excretion of sodium and water in the kidneys, leading to increased urine production. However, it can also cause the loss of potassium (hypokalemia) as a side effect. Hypokalemia can manifest with symptoms such as muscle weakness, fatigue, irregular heart rhythms, and muscle cramps.
Choice B Reason:
Hypermagnesemia is incorrect. Hydrochlorothiazide typically promotes the loss of magnesium rather than causing elevated magnesium levels.
Choice C Reason:
Hypernatremia is incorrect. Hydrochlorothiazide is more likely to cause a decrease in sodium levels (hyponatremia) rather than an increase (hypernatremia).
Choice D Reason:
Hypocalcemia is incorrect. Hydrochlorothiazide can cause increased excretion of calcium but it's not a common adverse effect compared to the loss of potassium (hypokalemia).
Correct Answer is D
Explanation
Choice A Reason:
Weight gain is incorrect. Weight gain is typically associated with fluid volume excess rather than deficit. In heart failure, fluid retention can lead to weight gain due to excess fluid accumulation in the body.
Choice B Reason:
Distended neck veins is incorrect. Distended neck veins are a sign of fluid volume excess, commonly seen in heart failure due to increased venous pressure and fluid retention.
Choice C Reason:
Shortness of breath is incorrect.: Shortness of breath is often associated with fluid accumulation in the lungs, known as pulmonary edema, which is a manifestation of fluid volume excess or fluid overload in heart failure.
Choice D Reason:
Elevated hematocrit level is correct. Furosemide is a diuretic that promotes diuresis (increased urine output), leading to fluid loss. When a client experiences fluid volume deficit or dehydration due to increased diuresis, there is a concentration of red blood cells in the blood, resulting in an elevated hematocrit level. This occurs because the blood becomes more concentrated when there's less fluid volume available.
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