Author Question: A patient tells the nurse during the health history that the last time she received penicillin, she ... (Read 141 times)

james · **on:** Jul 23, 2018

A patient tells the nurse during the health history that the last time she received penicillin, she experienced anaphylaxis. Which of the following medications should the nurse advise the patient to avoid?

a. Ibuprofen (Motrin)
b. Doxycycline (Vibramycin)
c. Imipenem (Primaxin)
d. Cefoxitin (Mefoxin)

Question 2

The nurse is caring for a patient taking vancomycin (Vancocin). Upon assessment of the patient, the nurse finds that he is experiencing flushing, rash, pruritus, and urticaria.

His vital signs are: P120, BP92/97, T98.9 F, and R20. The nurse understands that these findings are consistent with
a. red man syndrome.
b. rhabdomyolysis.
c. an allergic reaction.
d. Stevens-Johnson syndrome.

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

Answer to Question 1

ANS: D
Cephalosporins can be used with minimal concern in patients with a mild penicillin allergy; however, they should not be administered to patients with a history of a severe reaction to penicillin.
Motrin may increase the risk of bleeding, but the greater concern is anaphylaxis.
Benefits associated with doxycycline and imipenem outweigh the risk of anaphylaxis.

Answer to Question 2

ANS: A
Rapid infusion of vancomycin can cause flushing, rash, pruritus, urticaria, tachycardia, and hypotension, a collection of symptoms known as red man syndrome.
Rhabdomyolysis is not associated with the administration of vancomycin.
The patient's symptoms indicate an allergic reaction, but this is specifically red man syndrome.
The symptoms are not those of Stevens-Johnson syndrome, which manifests as blisters or sores (or both) on the lips and mucous membranes after exposure to the sun.