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 B
Explanation
Rationale:
A. Nitrates: Nitrates are primarily used to manage angina or heart conditions and are unrelated to acetazolamide or its potential for allergic reactions.
B. Sulfa-based medications: Acetazolamide is a carbonic anhydrase inhibitor that contains sulfonamide groups. Clients with a sulfa allergy may experience a cross-sensitivity reaction, so it's important to confirm any history of sulfa allergies before administration.
C. Mostly cloudy: This option does not relate to any medication classification and is incorrect.
D. Antilipemic agents: Antilipemics are used to lower cholesterol and are not related to acetazolamide or its potential for allergic reactions.
E. Proton pump inhibitors: Proton pump inhibitors are used to reduce stomach acid and do not have a known cross-sensitivity with acetazolamide.
Correct Answer is B
Explanation
Rationale:
A. Diazepam is a benzodiazepine used for anxiety and sedation but is not effective for treating malignant hyperthermia.
B. Dantrolene is the specific antidote for malignant hyperthermia, and the nurse should expect to administer it to help reduce the severe muscle contractions and hypermetabolism associated with this condition.
C. Cyclobenzaprine is a muscle relaxant used for muscle spasms but is not indicated for malignant hyperthermia.
D. Metaxalone is also a muscle relaxant, but like cyclobenzaprine, it is not effective for managing malignant hyperthermia and would not be used in this situation.