A patient is receiving cefazolin, a first-generation cephalosporin, for a surgical prophylaxis.
The nurse should assess the patient for which of the following possible allergic reactions? (Select all that apply.)

Urticaria

Bronchospasm

Anaphylaxis

Stevens-Johnson syndrome

Angioedema.

Answer and Explanation

Correct Answer : A,B,C,E

Cefazolin can cause serious or life-threatening allergic reactions in some patients, especially those with a history of penicillin allergy. The most common allergic reactions to cefazolin are immediate reactions, such as anaphylaxis, urticaria, bronchospasm, and angioedema. These reactions usually occur within one hour of the drug administration and may involve symptoms such as rash, itching, swelling, difficulty breathing, low blood pressure, and shock. Immediate reactions are mediated by immunoglobulin E (IgE) antibodies that bind to the drug and trigger the release of inflammatory mediators from mast cells and basophils.

Choice D is wrong because Stevens-Johnson syndrome is not a typical allergic reaction to cefazolin.

Stevens-Johnson syndrome is a rare and severe skin reaction that can be caused by various drugs, infections, or autoimmune diseases.

It involves blistering and peeling of the skin and mucous membranes, fever, malaise, and eye inflammation.

Stevens-Johnson syndrome is not mediated by IgE antibodies, but by other immune mechanisms that damage the skin cells.

Cefazolin is not known to cause Stevens-Johnson syndrome, although other cephalosporins have been reported to do so in rare cases.

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Free Nursing Study Resources

Correct Answer is ["A","B","C"]

Explanation

Here is why:

• Choice A:Monitor the client’s serum creatinine level.

This is correct because vancomycin can cause nephrotoxicity (damage to the kidneys) and serum creatinine is a marker of kidney function.A high serum creatinine level indicates impaired kidney function and may require dose adjustment or discontinuation of vancomycin.

• Choice B:Monitor the client’s serum vancomycin level.

This is correct because vancomycin has a narrow therapeutic range, meaning that there is a small difference between the effective dose and the toxic dose.Monitoring the serum vancomycin level can help to ensure that the drug is within the therapeutic range and avoid toxicity or suboptimal efficacy.

• Choice C:Infuse the drug over at least 60 minutes.

This is correct because vancomycin can cause a hypersensitivity reaction called “red man syndrome” or “red neck syndrome”, which is characterized by flushing, itching, rash, hypotension and tachycardia.

This reaction is not an allergy but a result of histamine release due to rapid infusion of vancomycin.Infusing the drug over at least 60 minutes can reduce the risk of this reaction.

• Choice D:Observe the client for signs of ototoxicity.

This is incorrect because vancomycin is not known to cause ototoxicity (damage to the ears) in humans.Ototoxicity has been reported in animal studies and in vitro studies, but not in clinical trials or case reports involving humans.

Therefore, there is no need to monitor for signs of ototoxicity such as hearing loss, tinnitus or vertigo.

A. Take the medication with or without food B. Report any signs of jaundice or dark urine C. Avoid drinking grapefruit juice while taking this medication D. Complete the full course of therapy as prescribed E. Store the medication in a cool and dry place.

Correct Answer is ["B","C","D"]

Explanation

Choice A is wrong because azithromycin (Zithromax) should be takenwith foodto prevent stomach upset.

Choice B is correct because azithromycin can causeliver damageand the client should report any signs ofjaundiceordark urineas they may indicate liver problems.

Choice C is correct because azithromycin can interact withgrapefruit juiceand increase the risk ofside effectssuch as nausea, vomiting, diarrhea, headache and QT interval prolongation.

Choice D is correct because the client shouldcomplete the full course of therapyas prescribed to prevent bacterial resistance and recurrence of infection.

Choice E is wrong because azithromycin should be stored in arefrigeratorand discarded after 10 days if it is in a liquid form.

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A patient is receiving cefazolin, a first-generation cephalosporin, for a surgical prophylaxis. The nurse should assess the patient for which of the following possible allergic reactions? (Select all that apply.)

Nursing Test Bank

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Explanation

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A patient is receiving cefazolin, a first-generation cephalosporin, for a surgical prophylaxis.
The nurse should assess the patient for which of the following possible allergic reactions? (Select all that apply.)