Exhibits

For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client's first dose of captopril.

Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.

Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Fluconazole is an antifungal medication that can affect blood glucose levels. It may increase the hypoglycemic effects of insulin, leading to lower blood glucose levels. The
client's insulin regimen may need to be adjusted while taking fluconazole.
Choice D rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Choice F rationale: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.

A. A scratchy throat can be an early sign of an allergic reaction to the antibiotic, which could progress to anaphylaxis if the infusion continues. Immediate cessation of the infusion is essential to prevent serious complications, and the nurse should notify the provider and initiate emergency interventions if needed.

B. Pupillary constriction is not a typical sign of an acute allergic reaction to piperacillin-tazobactam and does not warrant stopping the infusion.

C. Hypertension is not an expected early manifestation of an allergic reaction to this antibiotic. Blood pressure changes are more likely to occur later if anaphylaxis develops.

D. Bradycardia is not commonly associated with an early allergic reaction to antibiotics and does not require immediate cessation of the infusion unless other signs of anaphylaxis are present.