The nurse is monitoring a client taking a potassium sparing diuretic. Which of the following findings would prompt the nurse to notify the health care provider?

Choice A reason: This is correct. Hypertension is a contraindication for taking pseudoephedrine. Pseudoephedrine is a decongestant that shrinks the blood vessels in the nasal passages and relieves congestion. However, it can also increase the blood pressure and the heart rate, which can worsen hypertension and increase the risk of stroke, heart attack, or kidney damage. The nurse should advise the client to avoid pseudoephedrine and use other methods to relieve sinus congestion, such as saline nasal spray, steam inhalation, or humidifier.

Choice B reason: This is incorrect. Diverticulitis is not a contraindication for taking pseudoephedrine. Diverticulitis is a condition where small pouches in the colon become inflamed and infected. It can cause symptoms such as abdominal pain, fever, nausea, or constipation. Pseudoephedrine does not affect the colon or the inflammation directly, but it can cause dehydration, which can worsen constipation and diverticulitis. The nurse should advise the client to drink plenty of fluids and eat a highfiber diet to prevent constipation and diverticulitis.

Choice C reason: This is incorrect. Migraines are not a contraindication for taking pseudoephedrine. Migraines are severe headaches that are often accompanied by nausea, vomiting, or sensitivity to light and sound. They can be triggered by various factors, such as stress, hormones, or food. Pseudoephedrine does not cause migraines directly, but it can interact with some migraine medications, such as triptans, which are used to treat acute migraine attacks. The combination of pseudoephedrine and triptans can increase the blood pressure and the risk of serotonin syndrome, a serious condition that causes agitation, confusion, tremors, or seizures. The nurse should advise the client to check with their doctor before taking pseudoephedrine and triptans together.

Choice D reason: This is incorrect. Eczema is not a contraindication for taking pseudoephedrine. Eczema is a skin condition that causes dry, itchy, and inflamed skin. It can be caused by various factors, such as allergies, irritants, or genetics. Pseudoephedrine does not affect the skin or the inflammation directly, but it can cause dryness of the mucous membranes, such as the mouth, nose, or eyes. The nurse should advise the client to use a moisturizer, a lip balm, and artificial tears to prevent dryness and irritation of the skin and the mucous membranes.

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..