A nurse is transcribing a client’s prescription for erythromycin 500mg four times per day. Which of the following information should the nurse clarify with the provider?

Time

Dosage

Route

Medication

Answer and Explanation

The Correct Answer is A

A) Time: The time of administration is an important factor to clarify. The prescription specifies erythromycin 500mg four times per day, but it does not specify the exact times the medication should be administered. The nurse should clarify the specific times to ensure the medication is given at proper intervals, especially considering the potential for drug interactions and the timing of meals, which may impact absorption.

B) Dosage: The dosage of 500mg is specified clearly in the prescription. There is no indication that the dosage is incorrect or needs clarification. Erythromycin 500mg four times per day is a standard dose for certain infections, so no issues are apparent with the dosage itself.

C) Route: The route of administration (oral, intravenous, etc.) is not specified in the question but is typically understood unless otherwise stated. However, in the context of erythromycin, the most common route is oral. Unless there’s uncertainty about the route, it does not need clarification.

D) Medication: The medication is clearly identified as erythromycin, which is a known antibiotic. There is no ambiguity in the medication prescribed, so there is no need for clarification in this regard. The focus should be on confirming the time of administration.

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Correct Answer is D

Explanation

A) Slurred speech:
Slurred speech is not a common adverse effect of gentamicin. It could indicate neurological issues, but it is not typically associated with gentamicin use. If this occurs, the nurse should investigate other possible causes, such as a stroke or another neurological condition, rather than attributing it to the gentamicin.

B) Constipation:
Constipation is not a typical adverse effect of gentamicin. While antibiotics can sometimes cause gastrointestinal disturbances, gentamicin is more commonly associated with nephrotoxicity and ototoxicity, rather than constipation. If constipation occurs, it is more likely related to other factors such as diet or fluid intake.

C) Hypotension:
While hypotension can be a side effect of many medications, it is not a specific or common adverse effect of gentamicin. Gentamicin is more likely to cause nephrotoxicity and ototoxicity rather than significant blood pressure changes. However, hypotension could occur in the context of an infection or severe illness and should be monitored, but it is not directly associated with gentamicin.

D) New onset of hearing loss:
This is a well-known adverse effect of gentamicin. Gentamicin belongs to the class of antibiotics known as aminoglycosides, which can cause ototoxicity. New onset of hearing loss or tinnitus (ringing in the ears) is a significant warning sign of ototoxicity, which can occur due to gentamicin use. This side effect should be monitored closely, and if hearing loss occurs, the medication should be reevaluated, and alternatives should be considered.

A. I have occasional vaginal spotting." B. I have developed brown patches on my face." C. I have breast tenderness." D. I have intermittent calf pain."

Correct Answer is D

Explanation

A) I have occasional vaginal spotting: Vaginal spotting can occur as a side effect of medroxyprogesterone, especially in the first few months of use. While this should be monitored, it is not an immediate concern that requires urgent reporting unless the spotting becomes heavy or persistent, which could indicate other issues.

B) I have developed brown patches on my face: The development of brown patches on the face (known as melasma) is a known side effect of hormonal contraceptives, including medroxyprogesterone. Although this is an undesirable cosmetic effect, it is not an urgent medical concern that requires immediate attention.

C) I have breast tenderness: Breast tenderness is a common side effect of medroxyprogesterone and other hormonal medications. It is usually mild and resolves over time. While the client should continue to monitor the tenderness, it does not present an immediate risk or require urgent intervention.

D) I have intermittent calf pain: Intermittent calf pain could be a sign of a more serious complication, such as a deep vein thrombosis (DVT), especially since medroxyprogesterone can increase the risk of blood clots. This symptom should be reported immediately to the healthcare provider, as a DVT could potentially lead to a pulmonary embolism if left untreated, which is a life-threatening condition. Therefore, this is the priority finding to report.

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A nurse is transcribing a client’s prescription for erythromycin 500mg four times per day. Which of the following information should the nurse clarify with the provider?

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