A nurse is preparing to administer clindamycin to a client who states she forgot to report to the provider that she is allergic to penicillin. Which of the following actions should the nurse take?
Give the client the prescribed dose of the clindamycin.
Obtain a prescription for an alternative antibiotic.
Premeditate the client with epinephrine before administering the antibiotic.
Administer the clindamycin using a desensitization schedule.
The Correct Answer is B
Choice A Reason:
Giving the prescribed dose of clindamycin is not appropriate due to the reported penicillin allergy, which increases the risk of an allergic reaction.
Choice B Reason:
Obtain a prescription for an alternative antibiotic is correct. Given the client's reported allergy to penicillin, which is in the same antibiotic class as clindamycin (both are antibiotics that belong to the beta-lactam group), there is a higher risk of cross-reactivity and potential allergic reaction. Therefore, it's important to avoid administering clindamycin in such cases and seek an alternative antibiotic that does not have a similar chemical structure to penicillin to prevent an allergic reaction.
Choice C Reason:
Premeditating the client with epinephrine before administering the antibiotic is not a standard practice in this context. Epinephrine is used to treat severe allergic reactions but is not used as a preventive measure before administering antibiotics.
Choice D Reason:
Administering the clindamycin using a desensitization schedule might be an option in certain situations under the guidance of an allergist or immunologist, but it's not typically performed by nurses and requires a specific protocol and expertise in managing drug allergies. Obtaining an alternative antibiotic is a more appropriate and immediate action to avoid the risk of an allergic reaction in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Sodium 141 mEq/L is incorrect. This value is within the normal range (usually around 135-145 mEq/L).
Choice B Reason:
Potassium 2.5 mEq/ is correct. Furosemide, a loop diuretic, can lead to potassium loss through increased urine output. If a client already has a low potassium level (hypokalemia), administering furosemide can further decrease potassium levels, potentially causing or worsening hypokalemia. Hypokalemia can lead to various complications, including cardiac arrhythmias.
Choice C Reason:
WBC count 8,000/mm3 is incorrect. This value falls within the normal range for white blood cell count.
Choice D Reason:
INR 1.0: An INR of 1.0 is within the normal range for a person not on anticoagulation therapy.
Correct Answer is C
Explanation
Choice A Reason:
Serum osmolarity 310 mOsm/L is incorrect. Serum osmolarity measures the concentration of particles in the blood. While an elevated serum osmolarity might indicate dehydration, it's not a direct indicator of the effectiveness of treatment. It signifies the concentration of solutes in the blood rather than reflecting hydration improvement after treatment.
Choice B Reason:
Serum hematocrit 55%m is incorrect. Elevated hematocrit levels can occur in dehydration because of hemoconcentration (an increase in the concentration of red blood cells due to reduced fluid volume). However, similar to serum osmolarity, while it can indicate dehydration, it doesn't specifically reflect the effectiveness of treatment.
To determine effective treatment of dehydration, the nurse should consider the laboratory values that reflect hydration status:
Choice C Reason:
Urine specific gravity 1.020 is correct. Urine specific gravity measures the concentration of solutes in the urine, indicating the kidneys' ability to concentrate urine. A higher specific gravity (typically above 1.020) suggests more concentrated urine, which can indicate dehydration. As hydration improves, the urine becomes less concentrated, so a decrease in urine specific gravity toward the normal range (around 1.010-1.020) indicates effective rehydration and improved kidney function in retaining fluids.
Choice D Reason:
BUN 28 mg/dL is incorrect. Blood urea nitrogen (BUN) levels can also rise in dehydration due to reduced kidney perfusion. However, like serum osmolarity and hematocrit, while it can indicate dehydration, it doesn't directly show the effectiveness of treatment or the improvement in hydration status after treatment.
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