A client with a documented anaphylactic reaction to penicillin is prescribed cefazolin for surgical prophylaxis. Which nursing action is most appropriate?
Administer cefazolin as ordered, as cross-reactivity is negligible.
Hold cefazolin and notify the provider immediately.
Administer cefazolin with premedication of antihistamines and corticosteroids.
Administer cefazolin slowly with close monitoring for allergic reactions.
The Correct Answer is B
A. Administer cefazolin as ordered, as cross-reactivity is negligible.: Cefazolin is a first-generation cephalosporin with a higher potential for cross-allergy. Administering it without clarification places the client at significant risk for another anaphylactic reaction.
B. Hold cefazolin and notify the provider immediately.: The nurse should withhold cefazolin and promptly inform the healthcare provider. Cefazolin shares a similar beta-lactam structure with penicillin, and using it could trigger a severe hypersensitivity response requiring emergency treatment.
C. Administer cefazolin with premedication of antihistamines and corticosteroids.: Premedicating does not eliminate the risk of a true IgE-mediated anaphylactic reaction. Such an approach is unsafe as the reaction could still be life-threatening.
D. Administer cefazolin slowly with close monitoring for allergic reactions.: Giving the drug slowly does not prevent an anaphylactic response and may delay recognition of symptoms. The safest nursing action is to hold the medication entirely until an alternative antibiotic is prescribed by the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Migraine headaches associated with anxiety and stress.: Scopolamine is not indicated for migraines or anxiety-related headaches. Medications such as triptans, beta-blockers, or NSAIDs are more appropriate for migraine management rather than anticholinergic agents.
B. Viral infections associated with respiratory illness.: Scopolamine has no antiviral properties and does not treat respiratory infections. Its anticholinergic effects could thicken respiratory secretions, potentially worsening congestion or airway clearance.
C. Nausea and vomiting associated with motion sickness.: Scopolamine is an anticholinergic agent that blocks acetylcholine in the vestibular system, reducing nausea, vomiting, and dizziness caused by motion sickness. It is typically administered as a transdermal patch applied behind the ear several hours before travel.
D. Constipation associated with irritable bowel syndrome.: Scopolamine may actually worsen constipation because of its anticholinergic properties that slow gastrointestinal motility. It is contraindicated in clients with bowel obstruction or chronic constipation.
Correct Answer is C
Explanation
A. Hydroxychloroquine.: Hydroxychloroquine is an antimalarial and anti-inflammatory medication used in conditions such as rheumatoid arthritis and lupus. It has no antifungal properties and would not be effective for treating oral candidiasis (thrush).
B. Warfarin.: Warfarin is an anticoagulant used to prevent or treat thromboembolic disorders. It has no role in managing fungal infections and could even pose risks if given unnecessarily, such as increased bleeding tendency.
C. Nystatin.: Nystatin is an antifungal medication commonly prescribed for oral candidiasis, especially after prolonged antibiotic use that disrupts normal oral flora. It is typically administered as an oral suspension that the client swishes in the mouth and then swallows to eliminate the fungal overgrowth.
D. Ondansetron.: Ondansetron is an antiemetic used to prevent nausea and vomiting associated with chemotherapy, radiation, or surgery. It has no antifungal action and would not address the white oral lesions caused by Candida infection.
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