Which intervention is most important for the nurse to implement for a client who is receiving insulin lispro?

Choice A reason: This is the correct manifestation for the nurse to identify as a reason to stop the infusion. A scratchy throat may indicate an allergic reaction to piperacillin-tazobactam, which is a penicillin derivative. The client may also develop other signs of anaphylaxis, such as rash, itching, swelling, wheezing, or difficulty breathing. The nurse should stop the infusion immediately and notify the healthcare provider.

Choice B reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Pupillary constriction is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as light exposure, medication use, or neurological conditions. The nurse should monitor the client's pupils for any changes, but it is not a reason to stop the infusion.

Choice C reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Bradycardia, or a slow heart rate, is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as cardiac disorders, medication use, or vagal stimulation. The nurse should monitor the client's vital signs for any changes, but it is not a reason to stop the infusion.

Choice D reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Hypertension, or high blood pressure, is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as stress, pain, or renal disorders. The nurse should monitor the client's blood pressure for any changes, but it is not a reason to stop the infusion.

Choice A reason: This is not a correct instruction for the nurse to provide to the client. Stopping the oral contraceptive immediately is not necessary, as it may cause irregular bleeding, hormonal imbalance, or unwanted pregnancy. The client should continue taking the oral contraceptive as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.

Choice B reason: This is not a correct instruction for the nurse to provide to the client. Avoiding prolonged exposure to direct sunlight is not related to the interaction between oral contraceptive and erythromycin. This instruction may be relevant for other antibiotics, such as tetracyclines or sulfonamides, that can cause photosensitivity and increase the risk of sunburn. The client should protect the skin from sun exposure as part of general health promotion, but it is not specific to erythromycin therapy.

Choice C reason: This is not a correct instruction for the nurse to provide to the client. Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between oral contraceptive and erythromycin. Erythromycin is a macrolide antibiotic that can reduce the effectiveness of oral contraceptive by increasing its metabolism and clearance. The client should take the medications as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.

Choice D reason: This is the correct instruction for the nurse to provide to the client. Using an additional form of contraception is the best way to prevent pregnancy while taking erythromycin and oral contraceptive. Erythromycin can decrease the efficacy of oral contraceptive by increasing its metabolism and clearance. The client should use a barrier method or a spermicide, in addition to the oral contraceptive, while taking erythromycin and for at least one week after finishing the antibiotic course.