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 C
Explanation
Choice A Reason:
Ondansetron is incorrect. Ondansetron is an anti-nausea medication commonly used in cancer patients to manage nausea and vomiting, often caused by chemotherapy. It's not typically contraindicated or known to interact significantly with morphine administered via a PCA pump. This combination is often used to manage both pain and associated symptoms in cancer patients.
Choice B Reason:
Acetaminophen is incorrect. Acetaminophen is a pain reliever and fever reducer that doesn't typically interact significantly with morphine administered via a PCA pump. It's often used concurrently with other pain medications to manage discomfort in cancer patients. There isn't a known significant interaction between acetaminophen and morphine when used appropriately.
Choice C Reason:
Nalbuphine is correct. Nalbuphine is an opioid analgesic, similar to morphine, and administering it concurrently with morphine could potentially lead to opioid overdose or increased risk of opioid-related side effects such as respiratory depression. Thus, it's crucial to clarify with the provider whether there might be a potential interaction or if both medications are indeed necessary in this specific clinical scenario.
Choice D Reason:
Insulin glargine is incorrect. Insulin glargine is a long-acting insulin used to manage blood sugar levels in individuals with diabetes. While its interaction with morphine isn't typically a concern, it's essential to monitor blood sugar levels closely in individuals receiving opioids like morphine, as opioids can affect glucose metabolism and may necessitate adjustments in insulin dosage.
Correct Answer is D
Explanation
Choice A Reason:
Discard the medication if it is yellow is incorrect. While amphotericin B lipid complex can have a yellowish color, it's important to follow specific guidelines provided by the manufacturer or pharmacy regarding any discoloration or changes in the medication's appearance. Discoloration could indicate degradation or contamination, and it's crucial to adhere to specific institutional policies in such cases.
Choice B Reason:
Administer the medication over 2 hr is incorrect. Amphotericin B lipid complex is usually given over a longer duration (e.g., several hours) due to the potential for infusion-related reactions. Intermittent IV bolus administration over 2 hours might not be appropriate and can increase the risk of adverse reactions.
Choice C Reason:
Use a gravity flow set is incorrect. For medications like amphotericin B lipid complex, which often require precise infusion rates and careful monitoring, using an IV infusion pump is usually recommended instead of a gravity flow set. An infusion pump allows for more accurate control of the infusion rate and reduces the risk of errors.
Choice D Reason:
Prime the tubing with 0.9% sodium chloride is correct. Amphotericin B lipid complex should be administered according to specific instructions and precautions. Priming the IV tubing with 0.9% sodium chloride helps ensure that the medication is effectively delivered to the patient and that the medication is not affected by remnants of previous IV solutions in the tubing.
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