The nurse administers the initial dose of cefoxitin to a client whose medical record indicates an allergy to penicillin. Which finding is most important for the nurse to report to the healthcare provider?

A) Ask if the client’s morning voids are dark colored:
This intervention pertains to monitoring for potential adverse effects of carbidopa-levodopa, such as urine discoloration due to the breakdown of levodopa into dopamine. However, it does not directly address the client’s concern about the medication not working. While assessing for adverse effects is important, it may not provide immediate insight into the effectiveness of the medication in managing Parkinson’s disease symptoms.

B) Evaluate the client for signs of dyskinesia:
Dyskinesia refers to involuntary, abnormal movements that can occur as a side effect of long-term treatment with carbidopa-levodopa. While assessing for dyskinesia is essential during the management of Parkinson’s disease, it does not directly address the client’s immediate concern about the medication’s efficacy. It would be more appropriate to address the client’s primary concern first before assessing for potential adverse effects.

C) Determine if the client is taking the medication before meals:
The timing of medication administration, particularly with carbidopa-levodopa, can affect its absorption and effectiveness. Taking the medication with or without food can influence its onset of action and duration of effect. However, this intervention assumes that the client may not be taking the medication correctly, which may not necessarily be the case. It’s important to first clarify the client’s perception of the medication’s effectiveness before addressing administration instructions.

D) Explore what the client means by the drug “is not working.”
This option is correct. The nurse should prioritize exploring the client’s perception of the medication’s efficacy. Understanding the client’s specific concerns, such as which symptoms are not adequately controlled or how they define “not working,” can provide valuable information for further assessment and intervention. By actively listening to the client’s perspective, the nurse can collaboratively address any misconceptions, adjust the treatment plan if necessary, and provide education or reassurance accordingly.

A)Holds the pen in place after the injection:
This action is appropriate. Holding the auto-injector pen in place after administering the injection allows the medication to be fully delivered into the muscle. It ensures that the full dose of epinephrine is administered, which is crucial during an emergency situation such as anaphylaxis.

B) Administers into the fleshy outer thigh:
Administering the epinephrine injection into the fleshy outer thigh is the correct technique. The thigh muscle provides a large and accessible area for injection, allowing for rapid absorption of the medication into the bloodstream. This action facilitates the quick onset of epinephrine’s effects, which is vital in treating anaphylaxis.

C) Cleanses the injection pen for re-use:
This action requires intervention by the nurse. Epinephrine auto-injectors are designed for single use only and should not be cleansed or reused. Reusing the injection pen can lead to contamination, incorrect dosing, or malfunction, compromising its effectiveness during subsequent emergencies. It is essential to educate the client that the auto-injector pen is for one-time use only, and a new device should be used if another dose is required.

D) Inserts the injection pen through clothing:
While it is ideal to administer the injection directly onto bare skin, inserting the injection pen through clothing is acceptable in emergency situations when immediate access to bare skin is not possible. The priority during anaphylaxis is administering the epinephrine promptly. However, if feasible, the clothing should be moved aside to allow direct contact of the injection site with the skin for optimal absorption of the medication.