Question

Case Study #1 Ms. T., a 38-year-old secretary who has come to the clinic with a fever, sore throat, and cough that she has had for 2 days. Her posterior pharynx is reddened with patches of purulent exudate, and she complains that it hurts to swallow. Based on her symptoms and physical examination, the physician suspects a streptococcal infection. After a throat culture, the physician writes the following order: 10/30/20 Penicillin 500.0 mg B.I.D. for 10 days 0800 Steph Loccocus, MD---------------------------------------

1. Identify the errors in the order that the nurse must call the physician back for. A clarification of orders is needed for 3 errors.

2. Why you should find the physician’s name funny (LOL)?

3. Explain the rationale for obtaining a throat culture & sensitivity before the first dose of Penicillin is started.

4. Before giving the first dose of Penicillin, what additional assessment data does the nurse need to collect from B.T.?

5. What should the nurse teach B.T. about Penicillin?

Follow Up: After 7 days on the antibiotic, B. T. calls the office. Her throat is better, but she complains of severe perineal itching and has noticed a vaginal discharge. B. T. asks the nurse if she can stop taking the antibiotic.

1. What do you think has occurred?

2. What patient education should B. T. receive about finishing the antibiotic?

Answer 1

1) errors

• It is written BID instead of BD
• Name of doctor is not written
• Medicine should be given after swab result is obtained.

The correct prescription should be

Cap.Penicillin 500 mg B.D for 10 days

Name and signature of doctor

2)physicians name is not written .

Instead staphy Lococcus MD is written

3)

• Doctor order throat culture if the symptoms suggests streptococcal or staphylococcal or other infection.
• Symptoms includes redness, sweling, white streak or pus on tonsils ,red spots on roof of mouth and other signs of infection
• Throad swab cultured on blood agar plate has sensitivity rate of 90-95% .

4) ask whether patient is allergic to penicillin

5)

• Tell her to complete the course of antibiotics
• Take antibiotic after eating food only
• Stop antibiotic and come to hospital if you develop rashes, wheezing, ulcers on mouth or any other difficulty.

FOLLOW UP

1) Penicillin allergy

2) ask her to stop antibiotics and come to hospital

Give her antihistamine.

If symptoms of staphylococcal infection is not gone, give cephalosporins instead of penicillin.