A nurse is reviewing the medical record of a client who just returned to the unit following surgery and notes the client has a history of anaphylaxis in response to penicillin. The client's postoperative prescriptions include a dose of cephalexin. Which of the following actions should the nurse take?
Ask the provider to prescribe diphenhydramine as a precaution.
Hold the medication until the provider makes rounds.
Request that the surgeon prescribe a different antibiotic.
Administer the medication.
The Correct Answer is C
Rationale- The client is at risk of a life-threatening anaphylaxis as cross reactivity occurs between cephalosporin and penicillin as they both contain a beta lactam ring. Cephalexin should be avoided completely
A. Diphenhydramine is used for mild reactions but not anaphylaxis
B. waiting for rounds delays the client’s medication and hence inappropriate
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Demonstration is a measurable outcome. It allows the nurse to pick any errors in the performance of the task in real time and hence corrections can be made.
A, B and C are vague outcomes that are not feasible to measure.
Correct Answer is C
Explanation
Rationale-blowing the nose clears any mucus plugs allowing for optimal absorption
A. Lying on the side post application may lead to spillage of the applied drop
B. Holding the dropper too far leads to spillage with too little medication getting to the desired area
D. Tilting the head too long may lead to unnecessary irritation
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