Examkin

Question

Difficulty: MediumPharmacological Therapies

A practical nurse (PN) is reviewing the medication administration record for a client who is prescribed oral cephalexin for a wound infection. The client's medical history indicates a severe anaphylactic allergy to penicillin. Which of the following actions should the PN take?

  1. A
    Initiate continuous pulse oximetry monitoring and ensure oxygen is at the bedside before administering the dose.
  2. B
    Ask the client to sign a consent form acknowledging the risks before providing the medication.
  3. Withhold the cephalexin and promptly notify the registered nurse (RN) or healthcare provider.Answer
  4. D
    Independently decrease the medication dose by half to lower the risk of an allergic response.

Answer

The correct action is to withhold the medication and notify the RN or healthcare provider because cephalosporins, such as cephalexin, have a known risk of cross-sensitivity in clients with severe penicillin allergies.
The correct response prioritizes client safety by preventing a potential life-threatening allergic reaction. Cephalosporins (like cephalexin) and penicillins share a beta-lactam ring structure, meaning clients with a severe penicillin allergy have a significant risk of cross-anaphylaxis. The practical nurse must recognize this contraindication, withhold the scheduled dose, and communicate the finding to the supervising nurse or provider for a potential prescription change.

Step-by-Step Solution

1
Review the prescribed medication and the client's medical history.
The client is prescribed cephalexin and has a known anaphylactic allergy to penicillin.
Comparing new prescriptions against documented allergies is an essential safety check before any medication administration.
2
Analyze the pharmacological relationship between the prescribed drug and the allergen.
Cephalexin is a cephalosporin antibiotic, which shares a similar beta-lactam ring structure with penicillins.
Clients with severe penicillin allergies are at a significant risk for cross-sensitivity and may experience anaphylaxis if given a cephalosporin.
3
Determine the appropriate and safe nursing intervention within the practical nurse scope of practice.
The medication must be withheld and the finding escalated to the registered nurse or prescribing provider.
Withholding a contraindicated medication prevents patient harm, and notifying the provider allows for an alternative, safe antibiotic to be prescribed.

Key Concept

Cephalosporin and Penicillin Cross-Sensitivity
Rate this question

Topics

Pharmacological Therapies

More questions from this topic