A nurse is preparing to administer phenobarbital 3 mg/kg/day PO in two divided doses to a client who weighs 145 lb. The amount available is phenobarbital 100 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Breastfeeding. Ceftriaxone is generally considered safe during breastfeeding because only a small amount is excreted in breast milk. While monitoring for gastrointestinal disturbances or thrush in the infant is advised, breastfeeding is not a contraindication for ceftriaxone use.

B. Client allergy. The client has a penicillin allergy, which raises concerns about cross-reactivity with cephalosporins, including ceftriaxone. Although the cross-reactivity rate is low, clients with a history of severe allergic reactions (e.g., anaphylaxis, angioedema, or urticaria) to penicillin should avoid cephalosporins. The nurse should clarify the nature of the penicillin allergy before administering ceftriaxone.

C. Gentamycin prescription. Ceftriaxone and gentamicin are both nephrotoxic, and using them together increases the risk of kidney damage. The client should be monitored for renal function impairment, and alternative antibiotic therapy may be considered if necessary. The nurse should discuss this potential drug interaction with the provider before administration.

D. Hematocrit. The client’s hematocrit (32%) is low but does not require withholding ceftriaxone. A slightly decreased hematocrit is expected postpartum, especially in cases of infection or recent delivery. Ceftriaxone is not known to cause significant hematologic suppression that would make this a contraindication.

E. Hemoglobin. The client’s hemoglobin (9 g/dL) is lower than normal, likely due to postpartum blood loss or infection-related inflammation. However, ceftriaxone does not directly affect hemoglobin levels, so this is not a reason to withhold the medication.

A. Anorexia. Anorexia is a common side effect of sulfasalazine and is usually mild. It occurs due to the drug’s gastrointestinal effects but does not require immediate intervention. Managing symptoms with dietary modifications or taking the medication with food can help alleviate discomfort.

B. Arthralgia. Joint pain (arthralgia) can develop as a side effect of sulfasalazine, sometimes due to a drug-induced lupus-like reaction. Although it can cause discomfort, it is not immediately life-threatening. Monitoring symptoms and adjusting treatment may help manage this condition.

C. Nausea. Nausea frequently occurs with sulfasalazine use and is typically mild. It is often dose-dependent and can be managed by taking the medication with meals. While persistent nausea may require adjustments, it is not a medical emergency.

D. Wheezing. Wheezing suggests a hypersensitivity reaction, which can lead to anaphylaxis, a life-threatening emergency. Sulfasalazine contains a sulfa component, which may trigger bronchospasm, angioedema, or respiratory distress. Immediate intervention, including discontinuing the drug and administering emergency treatment, is necessary.