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 A
Explanation
Rationale:
A. Albuterol: This is a bronchodilator that can cause side effects such as increased heart rate and chest pain due to its stimulant effect on the cardiovascular system.
B. Furosemide: This diuretic is unlikely to cause chest pain directly; however, it may lead to electrolyte imbalances that can indirectly affect cardiac function.
C. Digoxin: While digoxin has several potential side effects, chest pain is not commonly recognized as a direct adverse effect of this medication.
D. Atenolol: This medication is a beta-blocker used to manage hypertension and is unlikely to cause chest pain; rather, it may help alleviate angina symptoms.
Correct Answer is C
Explanation
Rationale:
A. Applying a warming blanket is not appropriate and may worsen the client’s reaction to the infusion. It does not help prevent infusion-related reactions.
B. Infusing amphotericin B deoxycholate over 1 hour is too fast; the medication should be infused over 2-6 hours to reduce the risk of adverse effects.
C. Administering diphenhydramine prior to administration is recommended to help prevent infusion-related reactions, such as fever and chills, which the client experienced during previous infusions.
D. Monitoring vital signs once per hour is inadequate; vital signs should be monitored more frequently during and immediately after the infusion to promptly identify and manage any adverse reactions.