A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills. Which of the following actions should the nurse take?
Apply a warming blanket prior to administration.
Infuse the medication over 1 hr.
Administer diphenhydramine prior to administration.
Monitor vital signs once per hour following administration.
The Correct Answer is C
Rationale:
A. Applying a warming blanket is not appropriate, as it may exacerbate the client's reaction to the infusion and is not a standard pre-medication strategy.
B. Infusing amphotericin B deoxycholate over 1 hour is too rapid; it is typically infused over 2-6 hours to minimize adverse effects.
C. Administering diphenhydramine prior to the administration of amphotericin B can help prevent or alleviate infusion-related reactions such as fever and chills, which the client experienced during previous infusions.
D. Monitoring vital signs once per hour following administration is insufficient; vital signs should be monitored more frequently during and immediately after the infusion to promptly detect and address any adverse reactions.
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Correct Answer is C
Explanation
Rationale:
A. Monitoring alanine aminotransferase is important for liver function, but it is not the priority for a client on captopril.
B. Thyroid-stimulating hormone is not directly impacted by captopril and is not the priority lab value to monitor in this context.
C. Potassium is the priority laboratory value to monitor because captopril, an ACE inhibitor, can lead to hyperkalemia (elevated potassium levels), which can cause serious cardiac complications.
D. While magnesium levels are important to monitor, they are not specifically related to captopril therapy as potassium levels are.
Correct Answer is D
Explanation
Rationale:
A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.
B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.
C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.
D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.