The nurse observes a client with amyotrophic lateral sclerosis (ALS) is excessively drooling and prepares to suction the client's oral cavity.
Which action should the nurse include?

Choice A rationale:

The combination of trimethoprim and sulfamethoxazole has a synergistic effect, which means that the two drugs work together to inhibit bacterial growth more effectively than either drug alone. This combination is commonly used to treat urinary tract infections (UTIs) caused by susceptible bacteria.

Choice B rationale:

The combination of trimethoprim and sulfamethoxazole does not have an additive effect that reduces the dosage and frequency of administration of each drug. Instead, it is prescribed as a fixed combination with specific dosages of each drug.

Choice C rationale:

The combination of trimethoprim and sulfamethoxazole does not have an antagonistic effect that prevents the development of resistance to either drug. In fact, the combination is chosen because it covers a broader spectrum of bacteria and reduces the likelihood of resistance development.

Choice D rationale:

The combination of trimethoprim and sulfamethoxazole does not have a selective effect that targets only the bacteria causing the UTI and spares the normal flora. It affects a wide range of bacteria, including both pathogenic and normal flora.

This is the priority action by the practical nurse (PN) because it can help identify and prevent a potential adverse reaction to the medication. A client who is reaching saturation with medication means that the client has reached the maximum level of medication in the blood that can produce the desired therapeutic effect. However, this also means that the client is at a higher risk of developing toxicity or side effects from the medication. The PN should report the findings of muscle soreness, fatigue, and warm skin to the charge nurse, as these may indicate signs of inflammation, infection, or allergic reaction to the medication. The PN should also monitor the client's vital signs, oxygen saturation, and laboratory values, and document the findings. The charge nurse should notify the health care provider and adjust the medication dosage or regimen as ordered.

a) Administer a PRN dose of acetaminophen.

This is not the priority action by the PN because it does not address the underlying cause of the client's symptoms. Acetaminophen is an analgesic and antipyretic medication that can help reduce pain and fever. However, it does not treat inflammation, infection, or allergy, which may be the reasons for the client's muscle soreness, fatigue, and warm skin. The PN should administer a PRN dose of acetaminophen only after reporting the findings to the charge nurse and obtaining an order from the health care provider.

b) Encourage the client to drink fluids.

This is not the priority action by the PN because it does not address the underlying cause of the client's symptoms. Drinking fluids can help maintain hydration and electrolyte balance in the body, which are important for normal functioning of cells and organs. However, it does not treat inflammation, infection, or allergy, which may be the reasons for the client's muscle soreness, fatigue, and warm skin. The PN should encourage the client to drink fluids only after reporting the findings to the charge nurse and obtaining an order from the health care provider.

d) Monitor the client's serum lipid levels.

This is not the priority action by the PN because it is not related to the client's symptoms. Serum lipid levels are measures of fats and cholesterol in the blood, which are important for energy production, hormone synthesis, and cell membrane structure. However, they are not related to inflammation, infection, or allergy, which may be the reasons for the client's muscle soreness, fatigue, and warm skin. The PN should monitor the client's serum lipid levels only if they are prescribed a medication that can affect lipid metabolism, such as statins or fibrates.