A client has a new prescription for the maximum recommended dosage of piperacillin/tazobactam for nosocomial pneumonia. The nurse should report which laboratory finding to the healthcare provider before administering the prescribed dose?

A client has a new prescription for the maximum recommended dosage of piperacillin/tazobactam for nosocomial pneumonia. The nurse should report which laboratory finding to the healthcare provider before administering the prescribed dose?

• A. Elevated white blood cell count.
• B. Presence of gram positive bacteria in the sputum.
• C. Decreased creatinine clearance.
• D. Elevated cholesterol and lipoproteins.

Answer: (C)

Dosing of renally eliminated antibiotics must be adjusted based on renal function. Piperacillin/tazobactam is cleared by the kidneys, so when creatinine clearance is decreased, the drug can accumulate in the body. Administering the maximum recommended dose in this situation risks toxicity, so this lab finding should be reported so the provider can modify the dose or dosing interval before administration. Elevated WBC, presence of gram-positive bacteria in sputum, or elevated cholesterol do not directly dictate dose adjustments for this antibiotic.

Dosing of renally eliminated antibiotics must be adjusted based on renal function. Piperacillin/tazobactam is cleared by the kidneys, so when creatinine clearance is decreased, the drug can accumulate in the body. Administering the maximum recommended dose in this situation risks toxicity, so this lab finding should be reported so the provider can modify the dose or dosing interval before administration. Elevated WBC, presence of gram-positive bacteria in sputum, or elevated cholesterol do not directly dictate dose adjustments for this antibiotic.