A nurse is reviewing the medical record of a client who is to receive the first dose of cefoxitin, a cephalosporin via intermitent IV bolus Which of the following findings should the nurse Identify as a contraindication for the client to receive cefoxitin and report to the provider?
A recent history of diarrhea for 3 days.
Serum creatinine 0.8 mg/dL.
Severe allergy to amoxicillin.
A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq potassium chloride.
The Correct Answer is C
Cefoxitin is a cephalosporin antibiotic and can cause allergic reactions in people who are allergic to penicillin or other beta-lactam antibiotics like amoxicillin. Therefore, a severe allergy to amoxicillin is a contraindication for the client to receive cefoxitin, and the nurse should report this finding to the provider immediately.
A recent history of diarrhea for three days is not a contraindication for cefoxitin administration. However, the nurse should monitor the client for signs of diarrhea and report any worsening symptoms to the provider.
A serum creatinine level of 0.8 mg/dL is within the normal range and is not a contraindication for cefoxitin administration.
A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq potassium chloride is not a contraindication for cefoxitin administration. However, the nurse should assess the client's veins carefully before administering the medication and choose a different site or route for administration if necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
To obtain an accurate gentamicin serum level, the nurse should draw a trough level immediately before administering the next dose of medication and a peak level 30 minutes after the dose has been administered. The trough level measures the lowest concentration of the medication in the blood, while the peak level measures the highest concentration.
Correct Answer is B
Explanation
The correct answer is choiceb. Monitor the serum medication levels.
Choice A rationale:
Administering gentamicin with food is not necessary and does not minimize the risk of adverse effects. Gentamicin is typically given intravenously or intramuscularly, and food does not impact its administration or absorption.
Choice B rationale:
Monitoring the serum medication levels is crucial when administering gentamicin. Gentamicin has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Regular monitoring helps ensure the drug remains within the safe and effective range, reducing the risk of nephrotoxicity and ototoxicity.
Choice C rationale:
Limiting the client’s fluid intake is not recommended. Adequate hydration is important to help prevent nephrotoxicity, a known adverse effect of gentamicin. Ensuring the client has sufficient fluid intake can help protect kidney function.
Choice D rationale:
Instructing the client to report agitation is not directly related to minimizing the risk of adverse effects of gentamicin. While it is important for clients to report any unusual symptoms, agitation is not a common adverse effect of gentamicin. Monitoring for signs of nephrotoxicity (e.g., decreased urine output) and ototoxicity (e.g., hearing loss, tinnitus) is more relevant.
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