A patient has been receiving an antibiotic with a small therapeutic index for 10 days. Upon assessment, the nurse notes an increase in the drug's side effects. What would be the nurse's priority action?
a. Call the prescriber and have the antibiotic changed.
b. Suspect an allergic reaction and administer a PRN antihistamine.
c. Ask the prescriber to order a plasma drug level test.
d. Set up oxygen and obtain an order for an antagonist.
C
A narrow therapeutic index indicates that a drug is relatively unsafe and should be monitored closely. The nurse should have a blood level drawn to confirm suspicions of toxicity. The nurse would not have the antibiotic changed, because there is no cause at this time. The patient is un-likely to be experiencing an allergic reaction, because the antibiotic has been in the system for 10 days. The patient shows no signs of anaphylaxis, so oxygen and an antagonist are not indicated.
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