The nurse is caring for a client who is refusing to take their prescribed metformin (Glucophage). The nurse understands that the most common side effects of metformin are:

Choice A reason: Ancef (ciprofloxacin) is not the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Ancef is the brand name of cefazolin, which is a firstgeneration cephalosporin, a subclass of beta lactam antibiotics. Cefazolin is effective against gram-positive bacteria, but has limited activity against gram negative bacteria and anaerobes. Cefazolin is also susceptible to beta-lactamase enzymes, which are produced by some bacteria to degrade beta lactam antibiotics and confer resistance. The nurse should avoid using Ancef or any other beta lactam antibiotic for a client with a beta lactam resistant bacteria.

Choice B reason: Merrem (meropenem) is the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Merrem is the brand name of meropenem, which is a carbapenem, a subclass of beta lactam antibiotics. Meropenem is effective against a wide range of bacteria, including gram-positive, gram negative, and anaerobic bacteria. Meropenem is also resistant to most beta-lactamase enzymes, except for metallo-beta-lactamase’s, which are rare and can be detected by laboratory tests. The nurse should consider using Merrem or another carbapenem for a client with a beta lactam resistant bacteria, unless they have a history of allergy or intolerance to beta lactam antibiotics .

Choice C reason: Flagyl (metronidazole) is not the correct answer for the nurse who anticipates administering a broad spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Flagyl is the brand name of metronidazole, which is a nitroimidazole antibiotic. Metronidazole is effective against anaerobic bacteria and some protozoa, but has no activity against aerobic bacteria. Metronidazole is not a beta lactam antibiotic, and it is not affected by beta-lactamase enzymes. However, metronidazole is not a broad spectrum antibiotic, and it is not suitable for treating infections caused by aerobic bacteria, which are more common than anaerobic bacteria. The nurse should use Flagyl only for specific indications, such as bacterial vaginosis, trichomoniasis, or Clostridioides difficile infection .

Choice D reason: Zosyn (piperacillin tazobactam) is not the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacterium. Zosyn is the brand name of piperacillin tazobactam, which is a combination of penicillin, a subclass of beta lactam antibiotics, and a beta-lactamase inhibitor. Piperacillin is effective against some gram-positive and gram-negative bacteria, but it is susceptible to beta-lactamase enzymes. Tazobactam is a compound that binds to and inhibits some beta-lactamase enzymes, thereby protecting piperacillin from degradation and extending its spectrum of activity. However, piperacillin tazobactam is not effective against all types of beta-lactamase enzymes, especially those that are encoded by plasmids and can be transferred between bacteria. The nurse should not use Zosyn or any other beta lactam/beta-lactamase inhibitor combination for a client with a beta lactam resistant bacterium unless the specific type of beta-lactamase is known and susceptible to the inhibitor.

The correct answer is: a. Right route, c. Right dose, d. Right person, e. Right documentation, f. Right medication.

Choice A: Right route

The right route ensures that the medication is administered via the correct method, such as oral, intravenous, or intramuscular. This is crucial because different routes can affect the medication’s absorption and effectiveness. Administering medication via the wrong route can lead to ineffective treatment or even harm the patient.

Choice B: Right to refuse

While patients do have the right to refuse medication, this is not one of the five main rights of medication administration. The five main rights focus on the correct administration process to ensure patient safety and effective treatment.

Choice C: Right dose

The right dose ensures that the patient receives the correct amount of medication. Administering too much or too little can lead to adverse effects or ineffective treatment. This right involves verifying the prescribed dose and measuring it accurately.

Choice D: Right person

The right person ensures that the medication is given to the correct patient. This is typically verified using two identifyers, such as the patient’s name and date of birth, to prevent medication errors.

Choice E: Right documentation

The right documentation involves accurately recording the administration of the medication. This includes noting the time, dose, route, and any observations. Proper documentation is essential for maintaining accurate medical records and ensuring continuity of care.

Choice F: Right medication

The right medication ensures that the correct drug is given to the patient. This involves checking the medication label against the doctor’s order to prevent errors. Administering the wrong medication can have serious consequences.