A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider?

The client has a history of a severe penicillin allergy.

The client takes an aspirin daily.

The client reports a history of nausea with cefuroxime.

The client has a BUN level of 18 mg/dL

Answer and Explanation

The Correct Answer is A

A. The client has a history of a severe penicillin allergy:
Correct Answer: This is the priority information for the nurse to report to the provider.
Explanation: Cefuroxime is a cephalosporin antibiotic. Individuals with a history of severe penicillin allergy may also have an increased risk of cross-reactivity with cephalosporin antibiotics. This potential cross-reactivity needs to be evaluated by the provider to determine the safety of prescribing cefuroxime for the client.
B. The client takes an aspirin daily:
Incorrect Explanation: While the daily use of aspirin should be considered when prescribing medications, it is not the priority in this scenario.
Explanation: Aspirin use might affect bleeding risk, but it is not directly related to the potential interaction with cefuroxime. The client's severe penicillin allergy takes precedence in terms of immediate concern.
C. The client reports a history of nausea with cefuroxime:
Incorrect Explanation: A history of nausea with cefuroxime is relevant but is not as critical as the severe penicillin allergy.
Explanation: While the nurse should consider the client's history of nausea with cefuroxime, it is not as urgent as addressing the potential cross-reactivity with penicillin.
D. The client has a BUN level of 18 mg/dL:
Incorrect Explanation: The BUN level is not the priority in this context.
Explanation: A BUN level of 18 mg/dL is within the normal range and is not immediately relevant to the decision about prescribing cefuroxime.

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Correct Answer is A

Explanation

A. Hypomagnesemia:
Correct Answer: This electrolyte imbalance is the one the nurse should assess the client for.
Explanation: Lithium is primarily excreted by the kidneys, and its excretion can be influenced by factors that affect renal function, including electrolyte imbalances. Hypomagnesemia (low magnesium levels) can potentially reduce the excretion of lithium, leading to increased lithium levels in the blood. This can increase the risk of lithium toxicity, which can be dangerous. Therefore, monitoring magnesium levels is important in clients taking lithium.
B. Hyponatremia:
Incorrect Explanation: While hyponatremia (low sodium levels) is a potential concern, it is not as directly linked to lithium interaction as hypomagnesemia.
Explanation: Lithium can cause diabetes insipidus, which leads to excessive urination and subsequent loss of water and electrolytes, including sodium. However, hyponatremia is not the immediate electrolyte imbalance that arises due to the interaction with lithium.
C. Hypocalcemia:
Incorrect Explanation: Hypocalcemia (low calcium levels) is not a primary concern in the context of lithium use.
Explanation: Lithium does not have a direct interaction with calcium levels. Hypocalcemia is typically not a result of lithium use or its interaction with other factors.
D. Hypokalemia:
Incorrect Explanation: While electrolyte imbalances like hypokalemia (low potassium levels) can have health implications, it is not the primary electrolyte imbalance to be concerned about with lithium use.
Explanation: Hypokalemia is not a direct consequence of lithium interaction. Monitoring potassium levels is important for overall health, but it's not the primary electrolyte imbalance associated with lithium use and its potential interactions.

A. Chronic kidney disease B. Alcohol use disorder C. Hepatitis B vaccine within the last week D. Diabetes mellitus

Correct Answer is B

Explanation

A. Chronic kidney disease:
While high doses of acetaminophen can cause renal injury, it is not absolutely contraindicated in CKD. Acetaminophen is actually preferred over NSAIDs, which can worsen kidney function.
B. Alcohol use disorder:
Acetaminophen (Tylenol) is primarily metabolized in the liver. Clients with alcohol use disorder are at high risk for hepatotoxicity and liver failure, especially if they consume large amounts of alcohol or have pre-existing liver damage. Chronic alcohol use depletes glutathione, a substance needed to detoxify acetaminophen’s metabolites, increasing the risk of liver toxicity even at normal doses.

C. Hepatitis B vaccine within the last week:
Receiving the hepatitis B vaccine within the last week is not a contraindication for acetaminophen.
D. Diabetes mellitus:
Diabetes mellitus does not directly impact the use of acetaminophen. However, individuals with diabetes should be mindful of their overall health and potential interactions with other medications they might be taking.

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A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider?

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