A nurse is preparing to administer penicillin IM to an adult client. Which of the following angles should the nurse use for injection into the client's ventrogluteal muscle?

B. Before administering any medication, especially antibiotics like amoxicillin, the nurse must assess the patient for allergies or previous adverse reactions to amoxicillin or other beta-lactam antibiotics. Allergic reactions can range from mild rashes to severe anaphylactic reactions, so it's essential to confirm the

patient's allergy status and assess for any signs or symptoms of allergic reaction before proceeding with administration.

A. Flushing the IV site with normal saline is typically not required specifically before administering IV amoxicillin unless it is part of the institution's standard practice to flush all IV lines before and after medication administration.

C. While monitoring intake and output (I&O) is important for assessing fluid balance and kidney function, it is not directly necessary before administering IV amoxicillin unless there are specific concerns related to the patient's fluid status or renal function. However, it is good practice to have a general understanding of the patient's recent fluid intake and output patterns.

D. Creatinine clearance is a measure of kidney function. Checking the latest creatinine clearance result is important for assessing renal function, especially before administering medications excreted by the kidneys. However, amoxicillin is primarily excreted by the kidneys in its unchanged form, so knowing the patient's renal function status can help in determining the appropriate dosage or adjusting the dosing interval if necessary.

D. Blurred vision is a known adverse effect of metoclopramide. It can occur due to its effects on the central nervous system, including potential effects on visual processing. Patients should be informed about this potential side effect, and vision should be monitored periodically.

A. Metoclopramide can cause drowsiness or sedation, especially at higher doses or in susceptible individuals. Monitoring for sedation is important to ensure patient safety and adjust dosing as needed.

B. Urinary retention: Although less common, metoclopramide has been associated with urinary retention. Patients should be monitored for signs and symptoms of urinary difficulty or retention, especially if they have pre-existing urinary issues.

C. Hypertension: Metoclopramide can occasionally lead to an increase in blood pressure, particularly in patients who are predisposed to hypertension or have other cardiovascular risk factors. Blood pressure monitoring is important during treatment.