The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy.
Which other medication or medication class, if ordered, would be a potential interaction concern?

Choice A rationale:

Aspirin is known as a salicylate and a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking a certain natural substance in your body to reduce pain and swelling. However, one of the key reasons aspirin is administered to a patient with a history of myocardial infarction (MI) is due to its antiplatelet aggregate properties. This effect reduces the risk of stroke and heart attack. If a patient has recently had surgery on clogged arteries (such as bypass surgery, carotid endarterectomy, coronary stent), doctors may direct them to use aspirin in low doses as a “blood thinner” to prevent blood clots.

Choice B rationale:

While aspirin does have analgesic properties, meaning it can relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches, this is not the primary reason it would be administered to a patient with a history of MI. The main goal in this context is to prevent further cardiac events, which is achieved through aspirin’s antiplatelet effects.

Choice C rationale:

Aspirin does have anti-inflammatory properties and it may be used to reduce pain and swelling in conditions such as arthritis. However, in the context of a patient with a history of MI, the anti-inflammatory property is not the primary reason for administering aspirin. The key purpose is to leverage its antiplatelet effects to prevent further cardiac events.

Choice D rationale:

Aspirin can be used to reduce fever, which is what the term ‘antipyretic’ refers to. However, similar to the analgesic and antiinflammatory properties, the antipyretic property is not the primary reason for administering aspirin to a patient with a history of MI. The main goal is to prevent further cardiac events through its antiplatelet effects.

The correct answer is Choice C.

Let’s go through the calculation step by step:

Step 1: Identify the order and the available medication. The order is for dexamethasone (Decadron) 6mg IM. The available stock is dexamethasone 4mg/1ml in a 5ml multidose vial.

Step 2: Determine the amount of medication needed to fulfill the order. This is done by dividing the ordered amount by the concentration of the available medication.

So, we have:

Step 2 Calculation=Concentration of Available MedicationOrdered Amount Substituting the given values: Step 2 Calculation=4 mg/mL6 mg Step 3: Perform the calculation.

Step 3 Calculation=1.5 mL

So, the nurse will prepare 1.5 mL of this medication.

Now, let’s discuss the rationales for each choice:

Choice A rationale:

75 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.

Choice B rationale:

5 mLs is not the correct amount. This would also be a larger dose than ordered, which could lead to an overdose.

Choice C rationale:

1.5 mLs is the correct amount. This is calculated by dividing the ordered dose (6 mg) by the concentration of the available medication (4 mg/mL).

Choice D rationale:

15 mLs is not the correct amount. This would be a significantly larger dose than ordered, which could lead to an overdose.