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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?

A.

Apply a warming blanket prior to administration.

B.

Infuse the medication over 1 hr.

C.

Administer diphenhydramine prior to administration.

D.

Monitor vital signs once per hour following administration.

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

Rationale:

A. "Remove the patch for two to four hours daily.": This is incorrect because transdermal nitroglycerin patches should be worn continuously for 24 hours, with a scheduled time to remove them (usually overnight) to prevent tolerance.

B. "Apply a new patch each day after waking up.": This instruction is correct; clients should apply a new patch daily to ensure continuous therapeutic effects while also allowing a break to reduce tolerance.

C. "Cover the patch with plastic wrap.": This is incorrect; covering the patch with plastic wrap can alter the absorption of the medication and is not necessary.

D. "Replace the existing patch with a new patch as soon as anginal pain begins.": This is incorrect; clients should not replace the patch immediately for angina. Instead, they should use sublingual nitroglycerin for immediate relief and follow the prescribed patch schedule.

Correct Answer is A

Explanation

Rationale:

A. Increase fluids while taking the medication: Amitriptyline is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps to mitigate these effects and prevent dehydration and constipation.

B. Expect an elevation in blood pressure with initial doses of the medication: Amitriptyline can cause orthostatic hypotension rather than elevated blood pressure. Clients should be informed about the risk of dizziness or fainting.

C. Stop the medication immediately if urine becomes orange in color: Orange urine is not a common side effect of amitriptyline. Clients should not stop the medication without consulting their provider.

D. Take the medication in the morning: Amitriptyline has sedative effects and is typically taken at night to help manage sleep disturbances and reduce daytime drowsiness.

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