A client in the emergency department experienced a severe ...

[WWatsford]

A client in the emergency department experienced a severe allergic response to penicillin. The client tells the nurse this is the first time she has ever taken this particular drug.
 
  Which questions can the nurse ask to determine the reason for the allergic response?
  Standard Text: Select all that apply.
  1. Have you ever been exposed to mold?
  2. Do you eat animal products that have been exposed to antibiotics such as penicillin?
  3. Have you ever had another allergic reaction to a group of antibiotics called cephalosporins?
  4. Do you have any seasonal allergies?
  5. Do you have any diseases or are you taking any medications that suppress the immune system?

Question 2

A client being discharged with a prescription for penicillin also takes probenecid. The nurse explains that probenecid:
 
  1. prevents diarrhea often associated with penicillin.
  2. will prevent an allergic response.
  3. is a secondary antibiotic.
  4. will allow the penicillin to stay in the body longer.

[pocatato]

Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: Inadvertent exposure to mold could trigger an allergy to penicillin.
Rationale 2: Some farmers and ranchers use antibiotics such as penicillins to decrease the risk of infection in farm animals.
Rationale 3: There is a degree of cross-sensitivity between penicillin and cephalosporin drugs.
Rationale 4: Seasonal allergies do not predict a penicillin allergy.
Rationale 5: Immunosuppression or medications that challenge the immune system do not predict or cause a penicillin allergy.
Global Rationale: Prior exposure to penicillin is necessary for an allergic reaction, although this exposure may have occurred inadvertently through exposure to mold or by eating animal products that contain small amounts of penicillin. Allergy to one penicillin increases the risk of allergy to other drugs in this class. There is also a degree of cross-hypersensitivity between penicillins and cephalosporins.

Answer to Question 2

Correct Answer: 4
Rationale 1: Probenecid will not treat diarrhea associated with penicillin.
Rationale 2: Probenecid is not an anti-inflammatory, and will not prevent allergic responses.
Rationale 3: Probenecid is not an antibiotic.
Rationale 4: Probenecid prevents the renal excretion of penicillin and allows it to remain in the system longer.
Global Rationale: Probenecid decreases excretion of penicillins and can lead to antibiotic toxicity. This is sometimes a desired effect but the patient will require monitoring.

[WWatsford]

Excellent

[mohan]

Thanks for the timely response, appreciate it