The nurse administers the initial dose of cefoxitin to a client whose medical record indicates an allergy to penicillin. Which finding is most important for the nurse to report to the healthcare provider?

Diminished renal output.

Pruritis and macular rash.

Vomiting and diarrhea.

Vaginal discharge.

Answer and Explanation

The Correct Answer is B

A) Diminished renal output:
Diminished renal output could be a potential concern with cefoxitin administration, as it is primarily excreted by the kidneys. However, it is not specifically related to the client’s allergy to penicillin. While it warrants monitoring, it is not the most critical finding to report in this context.

B) Pruritis and macular rash:
The development of pruritis (itchiness) and a macular rash (flat, discolored skin lesions) following the administration of cefoxitin in a client with a documented allergy to penicillin is a significant finding. It suggests a possible allergic reaction to cefoxitin, which belongs to the cephalosporin class of antibiotics. Cross-reactivity between penicillin and cephalosporins is well-documented, with some cephalosporins having a higher risk of allergic reactions in individuals with penicillin allergy. Therefore, pruritis and rash in this context may indicate an allergic response, and it is crucial to report this finding promptly to the healthcare provider for further evaluation and management.

C) Vomiting and diarrhea:
While gastrointestinal symptoms such as vomiting and diarrhea can occur as adverse effects of cefoxitin, they are not specific to an allergic reaction and may occur with various medications. While it is essential to monitor for these symptoms, they are not the most important findings to report in the context of a known penicillin allergy.

D) Vaginal discharge:
Vaginal discharge is not typically associated with an allergic reaction to cefoxitin. While changes in vaginal discharge may be clinically relevant in certain contexts, such as indicating a possible yeast infection or bacterial vaginosis, it is not directly related to the client’s allergy to penicillin or the administration of cefoxitin.

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Correct Answer is B

Explanation

A) Stop the oral contraceptive immediately:
This instruction is incorrect and potentially dangerous. Abruptly stopping oral contraceptives can lead to unintended pregnancy and disrupt the client's menstrual cycle. It's essential for the client to continue taking their oral contraceptive unless instructed otherwise by their healthcare provider.

B) Use an additional form of contraception:
This is the correct action. Erythromycin is an antibiotic that can reduce the effectiveness of oral contraceptives by altering the gut flora and potentially interfering with their absorption. Therefore, it is recommended to use an additional form of contraception, such as condoms, while taking erythromycin to prevent unintended pregnancy.

C) Take the medications at least 12 hours apart:
While it's generally a good practice to space medications apart to avoid interactions, specific instructions regarding the timing of erythromycin and oral contraceptive administration should be obtained from the healthcare provider. Simply spacing the medications apart may not be sufficient to prevent contraceptive failure.

D) Avoid prolonged exposure to direct sunlight:
This instruction is unrelated to the interaction between erythromycin and oral contraceptives. Erythromycin can increase sensitivity to sunlight (photosensitivity), but this does not affect the effectiveness of oral contraceptives. Therefore, while it's important to advise clients to protect themselves from sun exposure while taking erythromycin, it's not directly related to contraceptive use.

Correct Answer is ["31"]

Explanation

To find out how many gtt/min the nurse should regulate the infusion;

We can use the following formula:

Flowrate(gtt/min) = Totalvolume(mL) / Time(min) × Dropfactor(gtt/mL)

Given:

Total volume = 500 mL

Time = 4 hours = 240 minutes (since 1 hour = 60 minutes)

Drop factor = 15 gtt/mL

Substituting the given values into the formula:

Flowrate(gtt/min) =500mL/240min ×15gtt/mL

After performing the calculation, we find that the flow rate equals 31.25 gtt/min.

So, the nurse should regulate the infusion to 31 gtt/min (rounded to the nearest whole number).

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The nurse administers the initial dose of cefoxitin to a client whose medical record indicates an allergy to penicillin. Which finding is most important for the nurse to report to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is B

Explanation

A client receives a prescription for dextrose 5% in water 500 mL IV to be infused over 4 hours. The IV administration set delivers 15 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)

Correct Answer is ["31"]

Explanation

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