Ed Beatty Is A 52-Year-Old Client With A Severe Sore Throat

Ed Beatty Is A 52 Year Old Client With A Severe sore throat

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 streptococcal pharyngitis. The primary care provider recommends treatment with an intramuscular injection of penicillin G. Before administering the medication, several critical steps must be taken to ensure safe and effective treatment. First, it is essential to gather comprehensive patient information, including a detailed allergy history, especially allergies to penicillin or other antibiotics, and current renal function status, considering his history of renal insufficiency. Conducting a thorough assessment of possible contraindications and previous reactions to medications is vital. This information helps prevent hypersensitivity reactions, which could be life-threatening. Additionally, baseline vital signs, renal function tests, and a recent medication history should be reviewed to inform treatment plans and anticipate potential complications.

When Mr. Beatty inquires why he cannot receive oral penicillin instead of an IM injection, the nurse should explain that the severity of his infection and his current condition necessitate the rapid onset of the antibiotic, which is best achieved through IM administration. Furthermore, in some cases, oral medications may not be suitable if the patient has issues with swallowing, gastrointestinal absorption, or compliance concerns. The nurse can clarify that the IM route ensures a higher absorption rate and quicker therapeutic effect, which is especially important in severe infections like streptococcal pharyngitis.

Before administering penicillin G, the nurse should have certain equipment readily available. This includes sterile syringes and needles appropriate for intramuscular injection, alcohol swabs for skin antisepsis, gloves to maintain aseptic technique, and an emergency kit containing medications and equipment to manage anaphylaxis or other adverse reactions. Having the emergency supplies available is crucial because, despite precautions, allergic or hypersensitivity reactions can occur, potentially leading to severe consequences such as anaphylactic shock or cardiac arrest. Proper preparation ensures readiness to respond swiftly and effectively in case of adverse events.

Following the administration of penicillin G, Mr. Beatty experiences a cardiac arrest but is successfully resuscitated. The potential causes of this severe adverse reaction could include an anaphylactic reaction, which triggers airway swelling, hypotension, and cardiovascular collapse. Allergic reactions to penicillin are often immune-mediated and can result in anaphylaxis, a life-threatening condition characterized by rapid-onset airway obstruction, circulatory collapse, and often cardiac arrest. Other contributing factors might include a previous hypersensitivity history or cross-reactivity with other beta-lactam antibiotics. Continuous monitoring post-administration is crucial, especially in patients with known allergies or prior reactions.

During discharge teaching, the nurse should provide comprehensive information about penicillin G, including the importance of reporting any signs of allergic reactions such as rash, itching, swelling, difficulty breathing, or dizziness. Patients should understand the need for adherence to prescribed treatment, even if symptoms improve early, to prevent resistance or recurrence. It is also vital to educate Mr. Beatty about potential side effects, such as local pain at the injection site, diarrhea, or superinfections. Since he has a history of renal insufficiency, discussions should include the importance of regular renal function monitoring and follow-up appointments. Lastly, the nurse should emphasize the importance of carrying medical alert identification indicating penicillin allergy, and inform him to seek immediate medical attention if any adverse symptoms occur.

References

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