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Difficulty: EasyPharmacological and Parenteral Therapies

A client diagnosed with bacterial pneumonia is prescribed intravenous ceftriaxone. While completing the admission history, the nurse discovers that the client has a documented history of anaphylaxis following amoxicillin administration. Which action is the priority for the nurse to take?

  1. Withhold the prescribed ceftriaxone and contact the healthcare provider immediately.Answer
  2. B
    Premedicate the client with intravenous diphenhydramine before administering the antibiotic.
  3. C
    Administer the medication slowly while closely monitoring the client's respiratory status.
  4. D
    Proceed with the infusion since ceftriaxone is a cephalosporin, not a penicillin.

Answer

Withhold the prescribed ceftriaxone and contact the healthcare provider immediately.
Ceftriaxone is a third-generation cephalosporin. Because cephalosporins and penicillins (like amoxicillin) are both beta-lactam antibiotics, they share a similar chemical structure. Clients with a history of severe allergic reactions (such as anaphylaxis) to penicillins have a significant risk of experiencing a cross-sensitivity reaction to cephalosporins. The safest and most appropriate action is to withhold the dose and consult the prescribing provider for an alternative therapy.

Step-by-Step Solution

1
Analyze the client's medication history and the newly prescribed medication.
The client has an allergy to amoxicillin (a penicillin) and is prescribed ceftriaxone (a cephalosporin).
Identifying potential drug interactions or allergies is a critical pre-administration safety check.
2
Evaluate the relationship between the prescribed medication class and the known allergen.
Penicillins and cephalosporins share a beta-lactam ring structure, creating a risk for cross-sensitivity allergic reactions.
Understanding pharmacological classifications helps predict potential adverse effects.
3
Determine the highest priority nursing action based on the potential risk.
The priority action is to prevent exposure to the allergen by withholding the medication and notifying the provider.
According to the ABCs (Airway, Breathing, Circulation), preventing an anaphylactic reaction takes precedence over administering the medication.

Key Concept

Cross-sensitivity exists between penicillins and cephalosporins, requiring the nurse to withhold the medication and notify the provider to prevent anaphylaxis.
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Topics

Pharmacological and Parenteral Therapies

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