The nurse has received an order to give imipenem-cilastatin (Primaxin) intravenously (IV) to a client. Which assessments should alert the nurse to contact the health care provider?
Standard Text: Select all that apply.
1. The client is allergic to penicillin.
2. The medication list includes antiseizure medications.
3. The client is an older adult with long-standing diabetes.
4. The urine culture and sensitivity reveals a urinary tract infection (UTI).
5. A wound culture is positive for methicillin-resistant Staphylococcus aureus (MRSA).
Correct Answer: 1,2,3
Rationale 1: Imipenem-cilastatin (Primaxin) is contraindicated in clients with a history of allergy to other carbapenems, cephalosporins, or penicillins.
Rationale 2: Imipenem-cilastatin (Primaxin) should be used cautiously in clients with a history of seizures due to an increased risk of seizure activity.
Rationale 3: Because the kidneys excrete imipenem-cilastatin (Primaxin), clients with renal impairment must be closely monitored and doses lowered.
Rationale 4: The presence of a UTI is not a contraindication for imipenem-cilastatin (Primaxin).
Rationale 5: Imipenem-cilastatin (Primaxin) is prescribed for strains of MRSA.
Global Rationale: Imipenem-cilastatin is contraindicated in patients who have experienced a severe allergic reaction to this drug, other carbapenems, cephalosporins, or penicillins. Because the kidneys excrete imipenem-cilastatin, patients with significant renal impairment must be carefully monitored and dosages lowered. This drug should be used cautiously in patients with brain lesions, head trauma, or a history of seizures due to an increased risk of seizures.
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