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 antacids can help reduce gastrointestinal discomfort, they do not interact specifically with levofloxacin or affect blood glucose levels.
Choice B rationale
Taking levofloxacin on an empty stomach can enhance absorption, but it does not affect blood glucose levels.
Choice C rationale
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken for arthritis pain, but they do not interact specifically with levofloxacin or affect blood glucose levels.
Choice D rationale
Levofloxacin can cause changes in blood glucose levels, so patients with diabetes who are on oral hypoglycemic medication should monitor their blood glucose levels more frequently while on levofloxacin.

Choice A rationale
Amoxicillin is a type of penicillin, and if a client has had a rash or any other allergic reaction to penicillin in the past, it’s possible they could have a similar reaction to amoxicillin. Therefore, the nurse should discuss with the provider the possibility of using a different antibiotic. This is important because allergic reactions to antibiotics can be severe and even life-threatening.
Choice B rationale
Administering the amoxicillin and keeping epinephrine on hand is not the best course of action. While epinephrine can be used to treat severe allergic reactions, it’s better to avoid the risk of an allergic reaction in the first place if possible.
Choice C rationale
Requesting the provider to prescribe an antihistamine would not address the potential for a serious allergic reaction to the amoxicillin. Antihistamines can help with mild allergic reactions, but they may not be sufficient for a severe reaction.
Choice D rationale
Asking for an order for a beta-lactamase resistant drug might not be necessary. Beta-lactamase resistant drugs are used to treat infections caused by bacteria that produce beta-lactamase, an enzyme that can break down and resist penicillins. However, the client’s allergy to penicillin does not necessarily mean that a beta-lactamase resistant drug is required.