The nurse interviews a client admitted for an outpatient procedure and enters a long list of home medications into the medical record.

The nurse observes several medications that are prescribed for the same indications.

Which instruction is best for the nurse to communicate to the client regarding the multiple prescriptions?

Choice A rationale: While monitoring temperature is important for a client with meningitis to track the resolution of infection, it is not a prerequisite for administering penicillin. It does not prevent life-threatening complications.

Choice B rationale: Assessing the level of consciousness is a critical part of the neurological assessment for meningitis. However, it is not the specific priority action required before administering a first dose of an antibiotic.

Choice C rationale: Penicillin carries a high risk of anaphylaxis. The nurse must verify the client's allergy history to ensure safety, as a previous reaction to penicillin or cephalosporins could lead to a fatal allergic response.

Choice D rationale: While cultures must be obtained before starting antibiotics, this question specifies the provider has already ordered the medication for an identified organism (Streptococcus pneumoniae), implying the diagnostic cultures have already been completed.

Stomatitis refers to the inflammation of the mouth and oral mucosa, which can cause pain and difficulty swallowing. In the context of a client receiving chemotherapy, stomatitis is a common side effect that can occur due to the effects of chemotherapy on rapidly dividing cells, including those in the oral cavity. When a client develops stomatitis, it is important for the practical nurse (PN) to obtain information about the client's ability to swallow during a focused assessment. This is because stomatitis can significantly impact a client's ability to eat and drink comfortably, which can lead to dehydration and malnutrition. Assessing the client's ability to swallow helps determine the extent of the issue and guides appropriate interventions and support.

Let's briefly evaluate the other options:

a) Urinary output.
Urinary output is not directly related to stomatitis. Stomatitis primarily affects the oral cavity, and its impact on urinary output is minimal or nonexistent. While monitoring urinary output is important for assessing hydration status, it is not the priority in this situation.

c) Frequency of bowel movements.
The frequency of bowel movements is unrelated to stomatitis. Stomatitis primarily affects the mouth, and its presence does not directly influence bowel movements. Assessing bowel movements may be relevant for other concerns, but it is not specifically related to stomatitis.

d) Blood pressure while standing.
Blood pressure while standing, also known as orthostatic blood pressure, is not directly relevant to stomatitis. Stomatitis primarily affects the oral cavity and does not typically have a direct impact on blood pressure. Assessing blood pressure while standing may be appropriate for other health concerns, such as orthostatic hypotension, but it is not the priority in this situation.

In summary, when a client receiving chemotherapy develops stomatitis, the practical nurse should focus on assessing the client's ability to swallow as it directly relates to the impact of stomatitis on the client's nutrition and hydration.