Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?
Recommend use of an over-the-counter antipyretic.
Determine if other adverse effects have developed.
Ask if the medication has been kept refrigerated.
Instruct the client to increase oral fluid intake.
The Correct Answer is B
- Recommend use of an over-the-counter antipyretic: While treating fever with an antipyretic like acetaminophen or ibuprofen may provide symptomatic relief, the priority in this scenario is to assess for other adverse effects of the medication. Fever can be a sign of an allergic reaction or other adverse effects to the antibiotic. Therefore, it is important to first assess for other symptoms before recommending symptomatic treatment.
B) Determine if other adverse effects have developed: This is the correct answer. The onset of a low-grade fever after starting a new medication, such as amoxicillin, warrants further assessment for other adverse effects. The nurse should inquire about other symptoms the client may be experiencing, such as rash, itching, swelling, difficulty breathing, or gastrointestinal disturbances, which could indicate an allergic reaction or other adverse effects.
C) Ask if the medication has been kept refrigerated: While it is important to ensure proper storage of medications, such as amoxicillin, which may require refrigeration, the onset of a low-grade fever is not typically related to medication storage. Therefore, this action would not address the client’s current symptoms and concerns.
D) Instruct the client to increase oral fluid intake: While maintaining adequate hydration is important for overall health and may help manage symptoms of illness, such as fever, the priority in this scenario is to assess for other adverse effects of the medication. Therefore, increasing oral fluid intake alone would not address the potential adverse effects of amoxicillin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: This action may prevent further administration of fluconazole, but it does not address the underlying concern of rising liver enzyme levels. Holding the dose and notifying the healthcare provider directly would be more appropriate.
B) Hold the dose and notify the healthcare provider of the changes in the laboratory studies: This is the correct response. RisIng liver enzyme levels, indIcated by an increasing trend in aspartate aminotransferase (AST), suggest potential liver dysfunction or damage, which can be a serious adverse effect of fluconazole. The nurse should hold the dose and promptly inform the healthcare provider for further evaluation and management.
C) Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests: Initiating the infusion without addressing the rising liver enzyme levels could potentially worsen liver function. It is essential to hold the dose and inform the healthcare provider before proceeding with further administration.
D) Begin the infusion and submit a drug reaction report to the nursing supervisor: While it's im’ortant to document adverse reactions and submit reports as appropriate, the priority in this situation is to hold the dose and notify the healthcare provider to address the rising liver enzyme levels.
Correct Answer is D
Explanation
- Begin cardioversion to stabilize heart rhythm: Cardioversion is not the appropriate intervention for digoxin toxicity. Digoxin toxicity can cause arrhythmias, but the initial action should be to assess and manage the underlying cause, rather than immediately proceeding to cardioversion.
B) Give digoxin by another route to slow absorption: Slowing the absorption of digoxin is not the appropriate action for treating digoxin toxicity. Instead, the focus should be on managing the existing toxicity and preventing further absorption by withholding additional doses.
C) Administer potassium to stabilize the heart rate: While potassium may be indicated as part of the treatment for digoxin toxicity, particularly if hypokalemia is contributing to the toxicity, it is not the initial action. The priority is to assess the client’s acid-base and electrolyte values to identify any abnormalities contributing to the toxicity.
D) Check acid-base and electrolyte values: This is the correct action. Digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia, hypercalcemia, and hypomagnesemia. Therefore, assessing the client’s acid-base and electrolyte values is essential to identify and correct any abnormalities contributing to the toxicity. Once identified, appropriate interventions can be implemented to manage the toxicity and stabilize the client’s condition.
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