The client prescribed ondansetron (Zofran) for persistent nausea and vomiting demonstrates understanding about his medication when he states:

Choice A reason: This is incorrect. A recent history of diarrhea for 3 days is not a contraindication for receiving a cephalosporin antibiotic. However, the nurse should monitor the client for signs of dehydration and electrolyte imbalance, and advise the client to drink plenty of fluids and avoid caffeine and alcohol. The nurse should also be aware that cephalosporins can cause or worsen diarrhea in some people, especially if they disrupt the normal flora of the gut. In rare cases, cephalosporins can cause a serious infection called Clostridioides difficile (C. difficile) colitis, which is characterized by severe diarrhea, abdominal pain, fever, and blood or pus in the stool. The nurse should instruct the client to report any of these symptoms and to avoid taking antidiarrheal drugs without consulting the doctor.

Choice B reason: This is incorrect. Serum creatinine 0.8 mg/dL is not a contraindication for receiving a cephalosporin antibiotic. Serum creatinine is a measure of kidney function, and a normal range for adults is 0.6 to 1.2 mg/dL. A high serum creatinine level may indicate kidney damage or impairment, which can affect the clearance of cephalosporins and increase the risk of toxicity. Therefore, the dose of cephalosporins may need to be adjusted in people with kidney problems, except for ceftriaxone and cefoperazone, which are excreted mainly through the bile. The nurse should check the client's renal function tests and the doctor's orders before administering a cephalosporin antibiotic.

Choice C reason: This is incorrect. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride is not a contraindication for receiving a cephalosporin antibiotic. Phlebitis is the inflammation of a vein, which can be caused by mechanical, chemical, or infectious factors. Some IV solutions, such as potassium chloride, can irritate the vein and cause phlebitis. However, this does not mean that the client is allergic or intolerant to cephalosporins, which are usually well tolerated by the veins. The nurse should assess the client's IV site for signs of phlebitis, such as redness, swelling, pain, or warmth, and change the site if needed. The nurse should also dilute the cephalosporin antibiotic according to the manufacturer's instructions and administer it slowly over the recommended time to minimize the risk of phlebitis.

Choice D reason: This is correct. A severe allergy to penicillins is a contraindication for receiving a cephalosporin antibiotic. Penicillins and cephalosporins belong to the same class of beta lactam antibiotics, which share a similar chemical structure. Therefore, people who are allergic to penicillins have a higher chance of being allergic to cephalosporins, especially the first and secondgeneration ones. An allergic reaction to cephalosporins can range from mild skin rashes to life-threatening anaphylaxis, which is a severe hypersensitivity reaction that causes difficulty breathing, low blood pressure, and shock. The nurse should ask the client about their allergy history and the type and severity of their reactions. The nurse should report any history of penicillin allergy to the doctor and avoid giving cephalosporins to the client unless the doctor confirms that it is safe to do so..

Choice A reason: This is correct. The liver is the main organ responsible for drug metabolism. The enzymes that the body uses to metabolize drugs are present throughout the body but are most abundant in the liver. The liver can transform drugs into more polar and water-soluble compounds, which can then be excreted by the kidneys or the biliary system.

Choice B reason: This is incorrect. The lungs are not primarily responsible for drug metabolism, although they can play a minor role in some cases. The lungs can metabolize some drugs that are inhaled, such as anesthetics, or drugs that circulate through the pulmonary blood vessels, such as propranolol. However, the lungs have a lower capacity and a lower variety of enzymes than the liver.

Choice C reason: This is incorrect. The heart is not responsible for drug metabolism, although it can be affected by it. The heart is the organ that pumps blood throughout the body, delivering oxygen and nutrients to the tissues and organs. The heart can be influenced by the pharmacokinetics and pharmacodynamics of drugs, which are the processes of drug absorption, distribution, metabolism, and excretion, and the effects of drugs on the body, respectively.

Choice D reason: This is incorrect. The kidney is not primarily responsible for drug metabolism, although it is important for drug excretion. The kidney is the organ that filters the blood and removes waste products and excess fluid as urine. The kidney can excrete drugs that are water-soluble or that are not reabsorbed by the tubules. The kidney can also metabolize some drugs, such as aspirin, but to a lesser extent than the liver.