The nurse is caring for a client receiving IVPB azithromycin. Which client data obtained by the nurse should be reported to the health care provider (HCP) prior to administering any additional doses?

Question

The nurse is caring for a client receiving IVPB azithromycin.  Which client data obtained by the nurse should be reported to the health care provider (HCP) prior to administering any additional doses?

Quizplus · Accepted Answer

All macrolide antibiotics (eg, azithromycin, erythromycin, clarithromycin) can cause a prolonged QT interval, which may lead to sudden cardiac death due to torsades de pointes. Therefore, an electrocardiogram (ECG) should be monitored. Concurrent use of macrolide antibiotics with other drugs that prolong QT interval (eg, amiodarone, sotalol, haloperidol, ziprasidone, azole antifungals) will further increase this risk. Macrolides can also cause hepatotoxicity when taken in high doses or in combination with other hepatotoxic medications such as acetaminophen, phenothiazines, and sulfonamides. Elevation of aspartate transaminase and alanine transaminase levels (liver enzymes) may indicate that hepatotoxicity is occurring, and the nurse should report these results to the HCP. (Option A) Nausea and vomiting can be side effects of azithromycin. They are not as concerning as the adverse reaction of prolonged QT interval. (Option B) A decrease in the WBC count would be expected as infection is resolving. (Option D) Fever may be present in a client with an infection. The nurse should use as-needed acetaminophen cautiously in a client also receiving azithromycin due to the risk of hepatotoxicity. Educational objective: Macrolide antibiotics (eg, erythromycin, azithromycin, clarithromycin) can cause QT prolongation, which can lead to life-threatening arrhythmias (eg, torsades de pointes). They can also be hepatotoxic; therefore, the nurse should monitor liver function tests and an ECG and report significant results to the HCP.

The Nurse Is Caring for a Client Receiving IVPB Azithromycin