A patient calls the clinic and reports feeling unwell, with symptoms of rapid heart rate, severe headache, and light-headedness. The nurse notes that the patient was prescribed metronidazole a few days ago.

What substance could likely be causing these symptoms?

Choice A rationale
While a fasting blood sugar level of 130 mg/dL is slightly elevated, it is not the most concerning finding given the current medications. Metformin is a medication used to control blood sugar levels in patients with diabetes, so this patient’s blood sugar is being managed.
Choice B rationale
Yellow discoloration of the sclera is a sign of jaundice, which can indicate liver damage. Given that this patient is taking several medications that can potentially cause liver damage (including isoniazid and acetaminophen), this finding is most concerning.
Choice C rationale
A positive result on the tuberculin skin test indicates exposure to tuberculosis, but it does not necessarily mean the patient has active tuberculosis. The patient is currently taking medications for tuberculosis (isoniazid and rifampin), indicating that this condition is being managed.
Choice D rationale
A blood pressure reading of 100/70 mmHg is within the normal range, so this would not be the most concerning finding. The patient’s metoprolol medication is used to manage blood pressure, indicating that this aspect of the patient’s health is being managed. Prednisone Prednisone Explore

Choice A rationale
While notifying the healthcare provider is an important step when an IV has infiltrated, it is not the immediate priority action.
Choice B rationale
Adding promethazine to the allergy list would not be appropriate unless the patient had an allergic reaction to the medication.
Choice C rationale
Continuing to monitor the site would not be the immediate priority action. The nurse should first stop the IV infusion to prevent further damage.
Choice D rationale
The nurse’s priority action should be to stop the IV infusion. This prevents further infiltration and potential tissue damage. After stopping the infusion, the nurse can then take further steps such as notifying the healthcare provider and assessing the patient’s condition.