A client has a new prescription for the maximum recommended dosage of piperacillin/tazobactam for a hospital acquired pneumonia (HAP). The nurse should report which laboratory finding to the healthcare provider before administering the prescribed dose?
Presence of gram positive bacteria in the sputum,
Elevated white blood cell count.
Elevated cholesterol and lipoproteins.
Decreased creatinine clearance.
The Correct Answer is D
A. Presence of gram positive bacteria in the sputum: Piperacillin/tazobactam is a broad-spectrum antibiotic effective against many gram-positive and gram-negative organisms. The presence of gram-positive bacteria alone does not contraindicate its use and would not require withholding the medication.
B. Elevated white blood cell count: An elevated WBC count is a common finding in pneumonia and indicates an active infection. This supports the need for antibiotic therapy and does not warrant holding the medication.
C. Elevated cholesterol and lipoproteins: High lipid levels are unrelated to piperacillin/tazobactam administration and do not affect its dosing or safety profile. These findings would not require delaying treatment.
D. Decreased creatinine clearance: Piperacillin/tazobactam is excreted primarily by the kidneys, and impaired renal function increases the risk of drug accumulation and toxicity. Dosage adjustment is necessary in renal impairment, so this finding should be reported before administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Assess for side effects of the medication: The first priority after a medication error is to assess the client’s immediate status for any adverse effects or signs of toxicity. This ensures prompt recognition and management of complications, prioritizing client safety before taking further reporting or documentation steps.
B. Complete a medication error report: Completing an incident report is essential for quality improvement and preventing future errors, but it is not the initial priority. Documentation and reporting should occur after the nurse ensures the client’s condition is stable.
C. Document the client's responses: Recording the client’s responses is an important step in monitoring and communicating the effects of the medication, but it follows immediate safety interventions such as assessing for side effects.
D. Determine if the pain was relieved: While evaluating pain relief is important in assessing medication effectiveness, it does not address the potential for harm from giving an inappropriate dose or drug. Ensuring safety takes precedence over evaluating therapeutic benefit.
Correct Answer is B
Explanation
A. Ensure a negative pregnancy test result 2 weeks before therapy: Misoprostol is contraindicated during pregnancy because it can cause uterine contractions and miscarriage. Confirming a negative pregnancy test before starting treatment is essential.
B. Begin therapy 1 week before the next normal menstrual cycle: Misoprostol should not be scheduled based on the menstrual cycle. Instead, therapy is initiated after confirming the client is not pregnant and with appropriate contraceptive measures in place.
C. Use condoms and a backup method of birth control to prevent pregnancy: Misoprostol poses significant teratogenic and abortifacient risks, reliable contraception with dual methods is strongly recommended throughout therapy. This is appropriate and safe guidance.
D. Call the healthcare provider immediately if there is a chance of conception: Prompt notification allows immediate discontinuation of the drug to reduce harm to a potential pregnancy. This is an important precaution to follow during misoprostol therapy.
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