QLexNursing

Request a prescription for an antiemetic medication.

💎 The nurse’s notes on Day 1 and Day 2 show the client has persistent nausea (“mild nausea” and “I am just not hungry right now”), and poor oral intake, which can lead to decreased nutrition and dehydration if not addressed.

💎 Nausea is also a common adverse effect of some antibiotics and illness-related stress, so managing it helps the client tolerate food and fluids, supporting healing.

💎 The client already has a history of fever and systemic infection, so maintaining hydration and nutrition is important to support immune function and recovery.

💎 There is no antiemetic listed in the provider prescriptions, so the nurse should proactively request an antiemetic to address the ongoing symptom.

💎 Addressing nausea early helps prevent worsening weakness, electrolyte imbalance, and further decline in oral intake, which are especially risky in a client with multiple comorbidities.

Clarify the prescription for amoxicillin with the provider.

💎 The medical history clearly states the client is “Allergic to penicillin”, and amoxicillin is a penicillin-class antibiotic.

💎 Giving amoxicillin to a client with a penicillin allergy can cause serious hypersensitivity reactions, including anaphylaxis, rash, or airway compromise.

💎 Safe medication administration requires the nurse to always compare allergies with current prescriptions and act when a conflict is found.

💎 The appropriate action is to clarify or question the amoxicillin order with the provider before administration, not to give it as written.

💎 This protects the client from a potentially life-threatening reaction and demonstrates professional advocacy and patient safety.

Place the client on contact precautions.

💎 By Day 3, the nurse’s notes document increasing abdominal cramping and pain and that the client has had three loose stools since 1000.

💎 The client has been receiving antibiotics (amoxicillin) and was just prescribed metronidazole, which is often used to treat Clostridioides difficile (C. diff) infection, a common cause of antibiotic-associated diarrhea.

💎 Clients with potential or confirmed C. diff should be placed on contact precautions to prevent fecal-oral spread to other patients and staff.

💎 Contact precautions include gown and gloves on entry and using dedicated equipment, as spores can survive in the environment and are highly transmissible.

💎 Instituting contact precautions promptly once infectious diarrhea is suspected is a critical infection-control responsibility.

Recommend increasing the dose of metoprolol.

💎 The client’s blood pressure and pulse are stable (around 110–112/60–66 and pulse ~70–72/min across days), showing no need for additional BP lowering.

💎 Increasing metoprolol without a clear indication could cause hypotension or bradycardia, compromising perfusion, especially while ill.

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

💎 Surgical masks are used primarily for droplet or airborne infections; this client’s problem is a UTI and possible C. diff–associated diarrhea, which are managed via contact, not droplet, precautions.

💎 The priority is gown and gloves and environmental cleaning, not routine surgical mask use for this diagnosis.

Hold the dose of levothyroxine.

💎 Levothyroxine is a lifelong replacement hormone for hypothyroidism and should usually be continued during acute illness unless specifically contraindicated.

💎 Holding it without a provider order may lead to worsening hypothyroid symptoms, such as fatigue, bradycardia, and slowed metabolism, which would hinder recovery.