The nurse is triaging phone calls at a clinic for a group of clients.
Which client situation requires immediate notification to the primary healthcare provider (PHCP)? A client who
The nurse is triaging phone calls at a clinic for a group of clients.
Which client situation requires immediate notification to the primary healthcare provider (PHCP)? A client who
A. reports a strong metallic-like taste while taking newly prescribed metronidazole.
[2%]
B. reports a localized rash after starting prescribed sulfamethoxazole-trimethoprim.
[15%]
C. takes prescribed lithium and reports blurred vision.
[76%]
D. feels restless and reports difficulty sleeping while taking prescribed prednisone.
[7%]
Statistics
Subject/Lesson
Subject
Leadership & Management
Lesson
Prioritization
Client Need
Test Plan
Management of Care
Related Topic
Establishing Priorities
Item Type
Item Type
Analysis
Explanation
Choice C is correct. Blurred vision usually occurs with advanced lithium toxicity (levels between 2.0 to 2.5 mEq/L (mmol/L)). This client's situation requires immediate follow-up because death may occur if this level of toxicity is not promptly treated. The maintenance level of lithium is 0.6-1.2 mEq/L (mmol/L).
Choice B is incorrect. Rash with sulfamethoxazole-trimethoprim (TMP-SMZ) is expected. This antibiotic is often prescribed for infections caused by Methicillin-resistant Staphylococcus aureus. The client should be advised to wear sunscreen when outdoors to prevent photosensitivity. A more serious rash, Stevens Johnson's syndrome, has been associated with this medication, but this complication does not feature a localized rash; it is more generalized and painful. This client situation does not require immediate follow-up because it is expected.
Choice A is incorrect. It is common for an individual taking metronidazole, an antibiotic, to experience a metallic-like taste. This sensation can be mitigated by having the client rinse their mouth frequently with oral rinses and using sugar-free candy. This is an expected finding and does not require immediate follow-up.
Choice D is incorrect. Prednisone has activating effects. This corticosteroid is used to treat an array of conditions, including dermatitis, exacerbations of autoimmune disorders, and adrenal insufficiency. Insomnia, agitation, and weight gain are expected, and the nurse should recommend that the client take this medication as early as possible in the day. This situation does not require immediate follow-up.
Related Videos
4 Key Topics
Mood Stabilizers (Lithium)
32.1 Psychopharmacology (Medications & Treatments)
Spectrum of Stability
