QLexNursing

Place the client on contact precautions.

💊 The client has had several days of diarrhea while receiving antibiotic therapy, and now has abdominal cramping and pain with fever 38.9°C.

💊 These findings are highly suspicious for Clostridioides difficile infection, especially in someone with recent antibiotic use and loose stools.

💊 Standard precautions for suspected or confirmed C. diff include contact precautions: private room if possible, gown and gloves, and soap-and-water hand hygiene.

💊 Initiating contact precautions early helps prevent spread of spores to other clients and staff, even as stool studies or orders are pending.

💊 Therefore, the nurse should place the client on contact precautions based on current symptoms and risk factors.

Request a prescription for an antiemetic medication.

💊 The client has reported ongoing nausea (“I am just not hungry right now”) with poor dietary intake, which can lead to dehydration, weakness, and delayed recovery.

💊 Treating nausea with an antiemetic can help improve oral intake, hydration, and overall comfort.

💊 The client is already dealing with diarrhea and infection, so maintaining nutrition and fluid status is especially important.

💊 There is no contraindication given for antiemetic use in this scenario, and the provider has not yet addressed this symptom directly with a medication order.

💊 Therefore, it is appropriate for the nurse to request a prescription for an antiemetic to manage symptoms and support recovery.

Clarify the prescription for amoxicillin with the provider.

💊 The medical history clearly states the client is “Allergic to penicillin.”

💊 Amoxicillin is a penicillin-class antibiotic, so giving it to a penicillin-allergic patient can cause hypersensitivity reactions, including anaphylaxis.

💊 Even if the client has tolerated some doses already, the nurse must treat this as a serious safety issue and avoid assuming it is safe.

💊 The nurse’s role includes medication safety and verification, so any order that conflicts with a known allergy must be clarified before further doses are given.

💊 Therefore, the nurse should immediately clarify the amoxicillin prescription with the provider due to the documented penicillin allergy.

Recommend increasing the dose of metoprolol.

💊 Metoprolol is a beta-blocker used to manage hypertension or tachycardia, and the client’s vitals do not show uncontrolled cardiovascular problems.

💊 Blood pressures are around 110–112/60–66 mm Hg, and pulse rates are 70–72/min, which are within acceptable, stable ranges.

💊 Increasing the dose of metoprolol in a client with infection and diarrhea could risk causing hypotension or bradycardia, especially as illness progresses.

💊 There is no indication in the data (no uncontrolled hypertension, no tachycardia) that would justify increasing the dose.

💊 Therefore, the nurse should not recommend increasing metoprolol; this action is inappropriate based on current assessment findings.

Hold the dose of levothyroxine.

💊 Levothyroxine treats hypothyroidism and is a chronic maintenance medication that should typically be continued unless there is a clear contraindication.

💊 There is no evidence in the scenario of overdose, thyrotoxicosis, or any condition that would require holding levothyroxine.

💊 Stopping levothyroxine abruptly without reason can lead to worsening hypothyroid symptoms, including fatigue, bradycardia, and slowed metabolism.

💊 Even in acute illness, many chronic medications like levothyroxine are continued unless specifically held by the provider.

💊 Therefore, the nurse should not hold levothyroxine based on the available information.

Ensure the client wears a surgical mask when they are outside of their room.

💊 Surgical masks for clients outside their room are mainly indicated for droplet or airborne respiratory infections (e.g., influenza, TB), not for UTI or C. diff diarrhea.

💊 This client’s issue is a UTI with possible antibiotic-associated diarrhea/C. diff, which requires contact precautions (gown, gloves, hand hygiene), not droplet isolation.

💊 There is no mention of cough, droplet-spread respiratory infection, or special respiratory isolation orders that would justify masking the client outside the room.

💊 The focus should be on contact precautions and environmental cleaning, not universal masking of the client.

💊 Therefore, having the client wear a surgical mask is not required for the current diagnoses and is not a priority action here.