The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant.
Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?

Choice A rationale:

Zidovudine, also known as AZT, is a medication used for the treatment of human immunodeficiency virus (HIV) infection. One of the major dose-limiting toxic effects of Zidovudine is hematologic toxicity, which manifests clinically as anemia, neutropenia, and sometimes as platelet deficits with onset after several weeks of treatment. This hematologic toxicity is essentially a form of bone marrow suppression. Therefore, bone marrow suppression is the dose-limiting adverse effect of zidovudine therapy.

Choice B rationale:

Retinitis is not a known dose-limiting adverse effect of zidovudine. While zidovudine has a range of side effects, retinitis is not commonly associated with its use.

Choice C rationale:

Renal toxicity is not a known dose-limiting adverse effect of zidovudine. While zidovudine can have various side effects, renal toxicity is not typically one of them.

Choice D rationale:

Hepatotoxicity is not the dose-limiting adverse effect of zidovudine. While severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of zidovudine, it is not considered the dose-limiting adverse effect. The dose-limiting adverse effect is more specifically related to hematologic toxicity, which includes bone marrow suppression.

Choice A rationale:

Reporting a near-miss using the facility’s recommended protocol and correcting the error on the MAR is the appropriate action. A “near-miss” in healthcare is a situation where an error could have happened, but didn’t, either by chance or timely intervention. It’s crucial to report these incidents as they provide valuable information for risk management and quality improvement. By analyzing near-misses, healthcare facilities can identify potential hazards and take preventive measures to ensure patient safety. Correcting the error on the MAR is also important to prevent the same mistake from happening in the future.

Choice B rationale:

Reporting the near-miss to the next shift before the next dose is due is not the best course of action. While it’s important to communicate any potential issues to the next shift, it’s more crucial to report the incident immediately using the facility’s recommended protocol. This allows for a timely investigation and corrective action. Waiting until the next shift could delay these processes and potentially put patient safety at risk.

Choice C rationale:

Correcting the MAR error but saying nothing because nothing happened is not an appropriate response. Even though the error did not result in any harm, it’s still important to report it. Near-misses are often indicators of underlying system issues that need to be addressed. By not reporting the incident, the opportunity to improve patient safety and prevent future errors is lost.

Choice D rationale:

Notifying the pharmacy about the error they almost caused is not the most appropriate action. While it’s important to communicate with the pharmacy if they were involved in the error, the first step should always be to report the near-miss using the facility’s recommended protocol. This ensures that the incident is properly documented and investigated, and that appropriate corrective actions are taken.