On Day 2 at 16:00, the client is kept NPO.
An exploratory laparotomy is scheduled for tomorrow at 06:00. Metoclopramide 10 mg IV every 6 hours and Cefazolin 2g IV on call for surgery are ordered.
Which of the following actions should the nurse assist with?

Choice A rationale:

Temperature is not a contraindication to cefazolin administration. While fever or temperature might indicate an infection or other condition that needs to be addressed, it does not by itself contraindicate the use of cefazolin. Cefazolin is an antibiotic, and its administration should be based on the presence of an infection and not solely on temperature readings.

Choice B rationale:

Allergy history is a significant contraindication for administering cefazolin. If the client has a known allergy or hypersensitivity to cefazolin or other cephalosporins, administering this medication could cause a severe allergic reaction, including anaphylaxis. Always review the client's allergy history before administering any medication to avoid such adverse effects.

Choice C rationale:

WBC count, although elevated in this scenario (13,000/mm³), is not a contraindication for cefazolin administration. An elevated WBC count may suggest an infection or inflammation, which might actually indicate a need for antibiotic therapy rather than contraindicate it.

Choice D rationale:

Amylase level is within normal range (80 units/L), so it does not contraindicate cefazolin administration. Elevated or abnormal amylase levels would be more relevant to concerns about pancreatitis or other pancreatic issues, but in this case, the level does not suggest a contraindication for cefazolin.

Choice E rationale:

Prescription for furosemide is relevant to consider as a potential contraindication due to the risk of nephrotoxicity. Cefazolin and furosemide both have the potential to impact kidney function. Using these medications together may increase the risk of renal impairment, especially in patients with pre-existing renal conditions. Therefore, it's important to monitor renal function closely when these medications are used together.

• Abdominal Pain: Common in both small bowel obstruction and acute pancreatitis.
• No Bowel Movement for 5 days: More indicative of small bowel obstruction.
• Vomiting: Can occur in both conditions.
• Abdominal Distention: Seen in both small bowel obstruction and acute pancreatitis.

• Increased Heart Rate: Can be a response to pain or infection in both conditions.
• Elevated Temperature: Can occur in both conditions due to inflammation or infection.
• Distention with fluid and gas in the small bowel (CT Scan): Specific to small bowel obstruction.
• Sodium: 130 mEq/L: Hyponatremia can be seen in both conditions.
• Potassium: 3.3 mEq/L: Hypokalemia can be seen in both conditions.
• WBC count: 10,000/mm: Leukocytosis can be seen in both conditions due to inflammation.