Author Question: A patient reports a severe urticarial reaction to benzathine penicillin G. The nurse would expect ... (Read 35 times)

mpobi80 · **on:** Jul 23, 2018

A patient reports a severe urticarial reaction to benzathine penicillin G. The nurse would expect the prescriber to order which alternative antibiotic?

a. Amphotericin B
b. Erythromycin (E-Mycin)
c. Ampicillin/sulbactam (Unasyn)
d. Ceftazidime (Fortaz)

Question 2

A patient is being treated with chloramphenicol (Chloromycetin) for an infection that has not responded to other antibacterial agents. A blood sample is drawn for determination of a serum trough level of the drug.

The level is reported as 15 mcg/mL. The nurse's priority action is to
a. administer the drug as scheduled.
b. request that the laboratory perform a confirming test.
c. withhold the drug and notify the prescriber.
d. expect the prescriber to increase the dose for subsequent administrations.

carlsona147 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Erythromycin is the first-choice treatment for several infections and may be used as an alternative to penicillin G in patients with a penicillin allergy.
Amphotericin B, ampicillin/sulbactam, and ceftazidime are not indicated as alternatives for patients with a penicillin allergy.

Answer to Question 2

ANS: C
The nurse should withhold the drug and notify the prescriber, because a trough level of 15 mcg/mL is high and may lead to aplastic anemia. The normal trough level is 5 to 10 mcg/mL.
The drug should not be administered as scheduled.
Nothing indicates that the measurement should be repeated.
An increase in the dose definitely would not be indicated, because the trough level is already high.