Ed Beatty is a 52-year-old client with a history of chronic renal insufficiency who presents to the medical clinic reporting a severe sore throat. He is diagnosed with a streptococcal pharyngitis. He is informed by the primary care provider that he will be treated with an IM injection of penicillin G. (Learning Objectives 2, 3, and 9)
1. What information should be collected from Mr. Beatty before the administration of the penicillin G?
2. Mr. Beatty asks why he cannot receive the medication in oral form. How should the nurse respond?
3. Describe the equipment that the nurse should have available before administering the medication to Mr. Beatty. Why is this necessary?
4. After receiving the penicillin G, Mr. Beatty experiences cardiac arrest. He is successfully resuscitated. Discuss the potential causes of the cardiac arrest.
5. Mr. Beatty has recovered from the arrest and the nurse is preparing his discharge teaching. What information related to the penicillin G should the nurse include?
Instructions:
- Your discussion post should be at least 140 words and include at least one 100-word response to a classmate. Follow APA guidelines for references. At least one
- Before administering penicillin G to Mr. Beatty, the nurse should collect the following information:
a) Allergies: It is crucial to ascertain if Mr. Beatty has any known allergies, especially to penicillin or other antibiotics. This information helps prevent potential allergic reactions.
b) Medical history: A comprehensive medical history should be obtained, including any previous adverse reactions to medications, current medications, and any existing medical conditions. This information can influence the decision to administer penicillin G and the dosage required.
c) Vital signs: Assessing Mr. Beatty’s vital signs, such as blood pressure, heart rate, and temperature, is important to establish baseline values and monitor for any abnormalities during and after the administration of the medication.
- When Mr. Beatty asks why he cannot receive the medication in oral form, the nurse can respond by explaining the rationale behind the choice of an intramuscular (IM) injection. The nurse can explain that an IM injection ensures a more rapid and reliable delivery of the medication into the bloodstream, which is necessary for effective treatment of streptococcal pharyngitis. The oral route may be less effective due to factors such as incomplete absorption, variable drug levels, and the potential for gastrointestinal disturbances.
- The nurse should have the following equipment available before administering penicillin G to Mr. Beatty:
a) Appropriate syringe and needle: A syringe and needle of the correct size for the IM injection should be prepared. The nurse should follow standard precautions and aseptic technique when handling the equipment.
b) Alcohol swabs: Alcohol swabs should be available to clean the injection site before administration, reducing the risk of infection.
c) Gloves: Wearing gloves is necessary to maintain proper hygiene and prevent the transmission of pathogens.
d) Sharps container: A sharps container should be readily accessible to safely dispose of used needles and syringes.
Having these equipment ready ensures a safe and efficient administration process.
- Several potential causes of cardiac arrest in Mr. Beatty following the administration of penicillin G could be considered:
a) Anaphylaxis: Although uncommon, severe allergic reactions can occur with penicillin G. Anaphylaxis can lead to respiratory distress, severe hypotension, and cardiac arrest if not promptly treated.
b) Medication error: If there was an error in the administration of penicillin G, such as an incorrect dosage or route, it could result in adverse effects, including cardiac arrest.
c) Underlying cardiac condition: Mr. Beatty’s chronic renal insufficiency and associated comorbidities may have contributed to an underlying cardiac condition, such as arrhythmias or ischemic heart disease, increasing the risk of cardiac arrest.
d) Unknown factors: Cardiac arrest can occur due to various unforeseen factors, such as an undiagnosed cardiac condition or an unanticipated reaction to the medication.
It is essential to investigate the cause thoroughly to guide appropriate management and prevent future occurrences.
- When preparing Mr. Beatty’s discharge teaching, the nurse should include the following information related to penicillin G:
a) Adverse reactions: Inform Mr. Beatty about potential adverse reactions to penicillin G, such as allergic reactions, including rash, itching, swelling, or difficulty breathing. Advise him to seek immediate medical attention if any symptoms occur.
b) Medication adherence: Emphasize the importance of completing the full course of prescribed medication to ensure effective treatment and prevent the development of antibiotic resistance.
c) Follow-up care: Discuss the need for a follow-up visit to monitor his condition, assess treatment effectiveness, and address any concerns or complications.
d) Allergy documentation: Advise Mr. Beatty to inform other healthcare providers about his penicillin allergy to prevent future exposures.
e) Emergency preparedness: Instruct Mr. Beatty on recognizing signs of severe allergic reactions and the appropriate actions to take, such as using an epinephrine auto-injector if available and seeking immediate medical help.
By providing this information, the nurse supports Mr. Beatty’s understanding of the medication and promotes his safety and well-being.
Response to classmate: I agree with your assessment of the potential causes of Mr. Beatty’s cardiac arrest following the administration of penicillin G. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can lead to cardiac arrest if not promptly treated. It is crucial to consider medication errors as a possible cause, as mistakes in dosage or route of administration can have serious consequences.
You mentioned that underlying cardiac conditions could contribute to the cardiac arrest. Indeed, chronic renal insufficiency is associated with an increased risk of cardiovascular disease, including arrhythmias and ischemic heart disease. These conditions can predispose individuals to cardiac arrest, especially when exposed to additional stressors such as medication administration.
It is essential to thoroughly investigate the cause of the cardiac arrest to guide appropriate management and prevent future occurrences. This may involve reviewing the medication administration process, assessing for potential allergies, and considering any underlying cardiac conditions. Implementing preventive measures, such as proper patient assessment and close monitoring, can help minimize the risk of such adverse events in the future.