A patient has been receiving intravenous penicillin for pneumonia ...

[future617RT]

A patient has been receiving intravenous penicillin for pneumonia for several days and begins to complain of generalized itching. The nurse auscultates bilateral wheezing and notes a temperature of 38.5 C (101 F).
 
  Which is the correct action by the nurse?
  a. Administer the next dose and continue to evaluate the patient's symptoms.
  b. Ask the prescriber if an antihistamine can be given to relieve the itching.
  c. Contact the prescriber to request an order for a chest radiograph.
  d. Hold the next dose and notify the prescriber of the symptoms.

Question 2

A nurse consults a drug manual before giving a medication to an 80-year-old patient. The manual states that elderly patients are at increased risk for hepatic side effects. Which action by the nurse is correct?
 
  a. Contact the provider to discuss an order for pretreatment laboratory work.
  b. Ensure that the drug is given in the correct dose at the correct time to minimize the risk of adverse effects.
  c. Notify the provider that this drug is contraindicated for this patient.
  d. Request an order to give the medication intravenously so that the drug does not pass through the liver.

[gstein359]

Answer to Question 1

ANS: D
Pruritus and wheezing are signs of a possible allergic reaction, which can be fatal; therefore, the medication should not be given and the prescriber should be notified. When patients are having a potentially serious reaction to a medication, the nurse should not continue giving the medication. Antihistamines may help the symptoms of an allergic reaction, but the first priority is to stop the medication. Obtaining a chest radiograph is not helpful.

Answer to Question 2

ANS: A
The drug manual indicates that this drug should be given with caution to elderly patients. Getting information about liver function before giving the drug establishes baseline data that can be compared with post-treatment data to determine whether the drug is affecting the liver. Giving the correct dose at the correct interval helps to minimize risk, but without baseline information, the effects cannot be determined. The drug is not contraindicated.

[future617RT]

TY

[gstein359]

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