Question

a nurse is caring for a client in a medical - surgical unit.
exhibit 1 exhibit 2 exhibit 3 exhibit 4
nurses notes
day 1:
client admitted with a diagnosis of venous thromboembolism (vte). client reports left calf pain, rated at a 5 on a 0 to 10 pain scale. edema +2 noted of left calf, no edema of right calf.
client reports allergies to levofloxacin.
day 3:
client reports productive cough and pain in chest when coughing. crackles heard in bilateral lower lobes on auscultation of lungs.
the nurse anticipates a prescription for an antibiotic medication. for each medication, click to specify if the medication is indicated or contraindicated for the client. there must be at least 1 selection in every row. there does not need to be a selection in every column.
medication contraindicated not contraindicated
ciprofloxacin ○ ○
telavancin ○ ○
sulfamethoxazole/trimethoprim ○ ○
linezolid ○ ○

Explanation:

1. Ciprofloxacin: Ciprofloxacin is a fluoroquinolone antibiotic, and the client is allergic to levofloxacin (also a fluoroquinolone). Cross - allergy within the fluoroquinolone class is common, so Ciprofloxacin is contraindicated.
2. Telavancin: Telavancin is a lipoglycopeptide antibiotic. There is no indication of allergy to this class or any contraindication related to the client's current conditions (VTE, new - onset respiratory symptoms), so it is not contraindicated.
3. Sulfamethoxazole/trimethoprim: This is a sulfonamide - based antibiotic. There is no reported allergy to sulfonamides or other contraindications related to the client's conditions, so it is not contraindicated.
4. Linezolid: Linezolid is an oxazolidinone antibiotic. There is no reported allergy to this class or other contraindications related to the client's conditions, so it is not contraindicated.

Answer:

• Ciprofloxacin: Contraindicated
• Telavancin: Not Contraindicated
• Sulfamethoxazole/trimethoprim: Not Contraindicated
• Linezolid: Not Contraindicated