A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider?
The client has a history of a severe penicillin allergy.
The client takes an aspirin daily.
The client reports a history of nausea with cefuroxime.
The client has a BUN level of 18 mg/dL
The Correct Answer is A
A. The client has a history of a severe penicillin allergy:
Correct Answer: This is the priority information for the nurse to report to the provider.
Explanation: Cefuroxime is a cephalosporin antibiotic. Individuals with a history of severe penicillin allergy may also have an increased risk of cross-reactivity with cephalosporin antibiotics. This potential cross-reactivity needs to be evaluated by the provider to determine the safety of prescribing cefuroxime for the client.
B. The client takes an aspirin daily:
Incorrect Explanation: While the daily use of aspirin should be considered when prescribing medications, it is not the priority in this scenario.
Explanation: Aspirin use might affect bleeding risk, but it is not directly related to the potential interaction with cefuroxime. The client's severe penicillin allergy takes precedence in terms of immediate concern.
C. The client reports a history of nausea with cefuroxime:
Incorrect Explanation: A history of nausea with cefuroxime is relevant but is not as critical as the severe penicillin allergy.
Explanation: While the nurse should consider the client's history of nausea with cefuroxime, it is not as urgent as addressing the potential cross-reactivity with penicillin.
D. The client has a BUN level of 18 mg/dL:
Incorrect Explanation: The BUN level is not the priority in this context.
Explanation: A BUN level of 18 mg/dL is within the normal range and is not immediately relevant to the decision about prescribing cefuroxime.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Decreased vomiting: This might improve as a result of the hypertonic solution treatment, but it is not a specific indicator of improved sodium levels.
B. Cardiac arrhythmias absent: While improvement in serum sodium levels can help prevent cardiac arrhythmias associated with hyponatremia, the absence of arrhythmias does not necessarily indicate that the sodium levels have normalized.
C. Absent Chvostek's sign: Chvostek's sign is associated with hypocalcemia, not hyponatremia. It is not directly related to the effectiveness of hypertonic solution treatment for hyponatremia.
D. Improved cognition
A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. The nurse should assess for improved cognition as an indicator that the treatment is effective.
Hyponatremia is a condition characterized by low levels of sodium in the blood. Hypertonic solutions, which have a higher concentration of solutes, are used to raise serum sodium levels. When the sodium levels return to a normal range, the client's cognitive function, including mental clarity and awareness, should improve. Other signs of improvement in hyponatremia include the resolution of symptoms related to fluid and electrolyte imbalance, such as nausea, vomiting, and muscle weakness.
Correct Answer is D
Explanation
A. Place the medications on the back of the client's tongue:
Incorrect Explanation: Placing medications on the back of the tongue can increase the risk of choking and aspiration, especially in individuals with dysphagia.
Explanation: Individuals with dysphagia have difficulty swallowing and are at an increased risk of choking or aspirating (inhaling) substances into the lungs. Placing medications on the back of the tongue can be unsafe and is not recommended.
B. Tilt the client's head back when administering the medications:
Incorrect Explanation: Tipping the head back can worsen swallowing difficulties and increase the risk of choking or aspiration.
Explanation: Tipping the head back can compromise the natural swallowing mechanism and increase the risk of aspiration. It's important to keep the client's head in an upright position to aid safe swallowing.
C. Administer more than one pill to the client at a time:
Incorrect Explanation: Administering multiple pills at once can increase the risk of choking and aspiration, especially in individuals with dysphagia.
Explanation: Administering multiple pills at once can overwhelm the client's ability to swallow safely. This action can increase the risk of choking and aspiration, which is especially dangerous for individuals with dysphagia.
D. Mix the medications with a semisolid food for the client:
Correct Answer: This action is appropriate and safer for administering medications to an older adult client with dysphagia.
Explanation: Mixing medications with semisolid food, such as applesauce or yogurt, can help the client swallow more easily and reduce the risk of choking or aspiration. It's important to check with the healthcare provider or pharmacist to ensure that the medications can be mixed with food and that there are no interactions.
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