Before administering amphotericin B to a patient, what is the most crucial step a nurse should take?

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.

Choice A rationale
This choice is correct. Calcium carbonate, which is used to treat GERD, can lead to hypercalcemia, or high levels of calcium in the blood, if taken in excess or if the client has impaired kidney function. Hypercalcemia can cause various symptoms, including nausea, vomiting, constipation, and abdominal pain. It can also affect the nervous system, leading to confusion, lethargy, and fatigue. In severe cases, it can cause cardiac arrhythmias.
Choice B rationale
Metabolic alkalosis is a condition characterized by a high level of bicarbonate in the blood, leading to an increase in blood pH. While antacids like calcium carbonate can potentially cause metabolic alkalosis if taken in large amounts, it is less likely to occur in patients taking the medication for GERD, as the medication is used to neutralize stomach acid. Therefore, while it’s a potential risk, it’s less likely than hypercalcemia.
Choice C rationale
Hepatotoxicity, or liver damage, is not typically associated with the use of calcium carbonate. This medication does not have a direct effect on the liver, so it’s unlikely to cause hepatotoxicity unless the client has an underlying liver condition or is taking other medications that can cause liver damage.
Choice D rationale
Hyperphosphatemia, or high levels of phosphate in the blood, is not typically a risk associated with the use of calcium carbonate. In fact, calcium carbonate can bind to phosphate in the gut and reduce phosphate absorption, which can help manage high phosphate levels in certain conditions. Therefore, this choice is not the most likely risk for the client.