A client receives a prescription for a secondary infusion of IV erythromycin 1 gram in 200 mL dextrose 5% in water (DW) to be infused in 90 minutes. The nurse should program the Infusion pump to deliver how many ml/hour? (Enter the numerical value only. If rounding is required, round to the nearest whole number.)

1. Recommend use of an over-the-counter antipyretic: While treating fever with an antipyretic like acetaminophen or ibuprofen may provide symptomatic relief, the priority in this scenario is to assess for other adverse effects of the medication. Fever can be a sign of an allergic reaction or other adverse effects to the antibiotic. Therefore, it is important to first assess for other symptoms before recommending symptomatic treatment.

B) Determine if other adverse effects have developed: This is the correct answer. The onset of a low-grade fever after starting a new medication, such as amoxicillin, warrants further assessment for other adverse effects. The nurse should inquire about other symptoms the client may be experiencing, such as rash, itching, swelling, difficulty breathing, or gastrointestinal disturbances, which could indicate an allergic reaction or other adverse effects.

C) Ask if the medication has been kept refrigerated: While it is important to ensure proper storage of medications, such as amoxicillin, which may require refrigeration, the onset of a low-grade fever is not typically related to medication storage. Therefore, this action would not address the client’s current symptoms and concerns.

D) Instruct the client to increase oral fluid intake: While maintaining adequate hydration is important for overall health and may help manage symptoms of illness, such as fever, the priority in this scenario is to assess for other adverse effects of the medication. Therefore, increasing oral fluid intake alone would not address the potential adverse effects of amoxicillin.

A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.

C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.

D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.