Discussion: Beatty, A 52-Year-Old Client With A History

Discussion 1ed Beatty Is A 52 Year Old Client With A History Of Chron

Discussion #1 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. 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. Follow APA guidelines for references.

Paper For Above instruction

Ed Beatty, a 52-year-old man with a history of chronic renal insufficiency, presents with streptococcal pharyngitis requiring intramuscular penicillin G. Prior to administration, it is essential to evaluate several critical factors. The nurse should gather comprehensive information about Mr. Beatty’s allergy history, especially any previous reactions to penicillin or other beta-lactam antibiotics, given the risk of anaphylaxis (Simons et al., 2016). Assessment of renal function is crucial because ongoing renal impairment influences drug clearance and dosing considerations (Blanchard et al., 2020). Additionally, renal laboratory values, such as serum creatinine and BUN, should be reviewed to mitigate potential toxicity. It is also important to assess for any contraindications or previous adverse reactions to antibiotics. Concerning the question about oral versus intramuscular administration, the nurse should explain that IM penicillin G provides a rapid and reliable therapeutic level, particularly important in treating streptococcal infections where adherence to oral therapy might be inconsistent or contraindicated.

Regarding equipment, the nurse should prepare sterile syringes, appropriate needle sizes, and resuscitation equipment including emergency medications, oxygen, and defibrillator pads. Having this equipment readily available ensures prompt management should an adverse reaction, such as an anaphylactic response, occur (Simons et al., 2016). During the administration, close monitoring of the patient’s vital signs is critical, especially considering Mr. Beatty’s renal status and recent severe reaction.

The occurrence of cardiac arrest after penicillin G administration warrants investigation into potential causes. Anaphylaxis remains the most severe hypersensitivity reaction associated with penicillin, which can lead to airway compromise, hypotension, and cardiovascular collapse (Mast et al., 2019). Rapid onset of anaphylactic shock could have precipitated cardiac arrest. Alternatively, if the patient experienced an allergic cardiotoxic reaction, it might have caused arrhythmias or myocardial ischemia. Other considerations include a pre-existing cardiac condition exacerbated by allergic response or unrecognized underlying cardiac disease. The successful resuscitation indicates prompt recognition and intervention.

Discharge teaching should emphasize early recognition of allergic reactions, including symptoms such as difficulty breathing, swelling, or rash, and instruct Mr. Beatty to seek immediate medical attention if symptoms recur (Mast et al., 2019). He should understand the importance of completing the full course of antibiotics if prescribed again, and notify all healthcare providers about his renal disease and previous adverse reactions. Also, guidance regarding the management of future allergic responses, including carrying warning identification or epinephrine auto-injector if indicated, should be provided. Proper documentation of the adverse event in his medical record is important to prevent repeat incidents.

References

• Blanchard, M., Baird, R., & Jacobs, F. (2020). Renal pharmacology principles and clinical implications. Journal of Nephrology Nursing, 32(4), 217-224.
• Mast, T. C., Campbell, R. L., & Ellis, A. K. (2019). Hereditary and acquired angioedema. Journal of Allergy and Clinical Immunology, 143(2), 524-534.
• Simons, F. E. R., Ardusso, L. R., Bilo, M. B., et al. (2016). World allergy organization anaphylaxis guidelines: 2020 update. World Allergy Organization Journal, 13, 100472.