A nurse is preparing to administer the initial dose of ceftriaxone to a client who has endometritis. Which of the following statements by the client should cause the nurse to hold the medication and consult the provider?

"I have a severe allergy to amoxicillin."

"I get sick when I take diuretics."

"I have a history of hearing problems."

"I take prednisone for my asthma."

Answer and Explanation

The Correct Answer is A

A. "I have a severe allergy to amoxicillin." A severe allergy to amoxicillin suggests a potential cross-reactivity with ceftriaxone, as both belong to the beta-lactam antibiotic class. While cross-reactivity between penicillins and cephalosporins is lower with third-generation cephalosporins like ceftriaxone, a history of severe allergic reactions, such as anaphylaxis, warrants consultation with the provider before administration.

B. "I get sick when I take diuretics." Adverse effects from diuretics do not typically indicate a contraindication to ceftriaxone. While diuretics like furosemide can interact with aminoglycosides to increase nephrotoxicity, ceftriaxone does not share this risk. Monitoring for individual tolerances is important, but this statement does not require holding the medication.

C. "I have a history of hearing problems." Ceftriaxone is not associated with ototoxicity, unlike aminoglycosides or vancomycin. A history of hearing problems does not necessitate withholding the medication, though the nurse should monitor for any new or worsening symptoms if concurrent ototoxic medications are prescribed.

D. "I take prednisone for my asthma." Corticosteroid use does not directly contraindicate ceftriaxone administration. While prolonged corticosteroid therapy may increase the risk of infections or mask symptoms of an allergic reaction, it does not warrant holding the antibiotic. The nurse should continue routine monitoring but can safely proceed with administration.

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Correct Answer is B

Explanation

A. "Your provider will be here later today." Informing the guardian about the provider’s availability does not directly address their request or provide immediate support. While the provider plays a role in discharge planning, the nurse should offer guidance and resources to help the guardian understand the process of taking the child home.

B. "I can give you information on what that would involve." Acknowledging the guardian’s request and offering relevant information demonstrates support and facilitates informed decision-making. Providing education on home care, hospice options, and necessary resources ensures that the guardian is prepared for the transition while maintaining open communication.

C. "I understand how you feel. I felt the same way when my sibling was terminally ill." Sharing personal experiences shifts the focus away from the guardian’s concerns and may not be appropriate in a professional setting. While empathy is essential, the response should remain patient-centered and focused on providing relevant information and support.

D. "I think you should speak with social services about your request." Referring the guardian to social services may be part of the process, but immediately redirecting the conversation does not acknowledge their concerns. The nurse should first provide direct information and reassurance before involving additional support services as needed.

A. Provide educational in-services for staff. B. Develop a MRSA protocol for implementation. C. Evaluate outcomes resulting from interventions. D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.

Correct Answer is D

Explanation

A. Provide educational in-services for staff: While staff education is an important component of a quality improvement project, it is not the first action to take. Understanding the underlying factors contributing to MRSA infections should be the priority to ensure that educational initiatives are targeted and relevant.

B. Develop a MRSA protocol for implementation: Developing a protocol is necessary for guiding practice and reducing infections. However, it is essential to first gather data on existing practices and factors contributing to MRSA infections to ensure the protocol addresses specific issues.

C. Evaluate outcomes resulting from interventions: Evaluation of outcomes is a crucial step in the quality improvement process but occurs after implementing interventions. Initial actions should focus on identifying the root causes of MRSA infections before assessing the effectiveness of any interventions.

D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA: Conducting a chart review is the first action the nurse manager should take. This step allows for the identification of patterns and factors contributing to MRSA infections, providing valuable data that will inform the development of effective protocols and interventions tailored to the facility's needs.

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A nurse is preparing to administer the initial dose of ceftriaxone to a client who has endometritis. Which of the following statements by the client should cause the nurse to hold the medication and consult the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The guardian of a child who has a terminally illness tells a nurse that they want to take their child home. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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