A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?
Contact the healthcare provider.
Give with prescribed antihistamine.
Administer the medication as prescribed.
Monitor the client for a rash or hives.
The Correct Answer is A
Choice A Reason:
Contact the healthcare provider: Given the client’s history of anaphylactic reaction to penicillin, there is a potential risk of cross-reactivity with cephalexin, a cephalosporin. Although the risk of cross-reactivity is relatively low, it is still significant enough to warrant caution. Studies indicate that 1-4% of people with a true penicillin allergy may also react to cephalosporins. Therefore, the nurse should contact the healthcare provider to discuss alternative antibiotics or additional precautions.
Choice B Reason:
Give with prescribed antihistamine: While antihistamines can help manage mild allergic reactions, they are not sufficient to prevent or treat anaphylaxis. Anaphylactic reactions require immediate medical intervention, including epinephrine administration. Therefore, relying solely on antihistamines is not an appropriate or safe action in this scenario.
Choice C Reason:
Administer the medication as prescribed: Administering cephalexin without consulting the healthcare provider could put the client at risk of a severe allergic reaction. Given the client’s history of anaphylaxis to penicillin, it is crucial to verify the safety of cephalexin with the healthcare provider before administration.
Choice D Reason:
Monitor the client for a rash or hives: While monitoring for allergic reactions is essential, it should not be the primary action in this case. The priority is to prevent a potential severe allergic reaction by consulting the healthcare provider before administering the medication. Monitoring alone does not address the underlying risk of cross-reactivity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Giving the next scheduled dose without further assessment is not advisable. An INR of 2.8 is within the therapeutic range for many conditions treated with warfarin, but it is important to ensure that the INR is stable and not trending higher, which could increase the risk of bleeding.
Choice B reason: Obtaining another blood sample might be necessary if there is suspicion of an error or if the INR is unexpectedly high or low. However, in this scenario, the INR is within the therapeutic range, so this action is not immediately necessary.
Choice C reason: Monitoring for signs of bleeding is always important for clients on warfarin, but it does not address the immediate need to communicate with the healthcare provider about the current INR level and any potential adjustments to the medication.
Choice D reason: Notifying the healthcare provider is the most appropriate action. The healthcare provider needs to be aware of the current INR level to make any necessary adjustments to the warfarin dosage and to provide further instructions on monitoring and follow-up.
Correct Answer is B
Explanation
Choice A Reason:
Notifying the healthcare provider of the contraindication to tetracyclines is not necessary in this context. Doxycycline, a type of tetracycline, is commonly prescribed and does not have a direct contraindication with birth control pills. However, the nurse should be aware of potential interactions and advise the client accordingly.
Choice B Reason:
Advising the client that the birth control pills will be less effective while taking doxycycline hyclate is crucial. Antibiotics like doxycycline can reduce the effectiveness of hormonal contraceptives, increasing the risk of unintended pregnancy. The client should be informed about this interaction and advised to use an additional non-hormonal method of contraception, such as condoms, while taking the antibiotic and for a short period after completing the course.
Choice C Reason:
Instructing the client to take the two medications at least two hours apart is not relevant in this case. The interaction between doxycycline and birth control pills is not related to the timing of administration but rather to the potential reduction in the effectiveness of the contraceptive.
Choice D Reason:
Encouraging the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate is not advisable. Stopping birth control pills can lead to a disruption in the contraceptive regimen and increase the risk of unintended pregnancy. Instead, the client should be advised to use an additional method of contraception.
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