Questions: A male client with meningitis is prescribed cefotaxime IV and asks the nurse why he cannot receive an oral drug, such as cefaclor or cefadroxil, that he has taken before for infections. How should the nurse respond when considering the actions of cephalosporins? - Cefazolin is another IV antibiotic that can be prescribed. - Cefaclor is a good alternative to suggest to the healthcare provider. - Cefadroxil is usually prescribed when the IV is discontinued. - Cefotaxime provides therapeutic CNS concentrations.

The answer is the fourth one: Cefotaxime provides therapeutic CNS concentrations.

Explanation for each option:

1. Cefazolin is another IV antibiotic that can be prescribed.

   • This statement is true, but it does not directly address the client's question about why an oral drug cannot be used. Cefazolin is indeed an IV antibiotic, but it is not specifically noted for its ability to penetrate the central nervous system (CNS) effectively.

2. Cefaclor is a good alternative to suggest to the healthcare provider.

   • Cefaclor is an oral cephalosporin, but it is not suitable for treating meningitis because it does not achieve adequate concentrations in the CNS. Therefore, it is not a good alternative for this condition.

3. Cefadroxil is usually prescribed when the IV is discontinued.

   • While cefadroxil is an oral cephalosporin that might be used for other infections, it is not appropriate for treating meningitis due to its poor CNS penetration. This option does not address the need for effective CNS concentrations.

4. Cefotaxime provides therapeutic CNS concentrations.

   • This is the correct response. Cefotaxime is a third-generation cephalosporin that can cross the blood-brain barrier and achieve therapeutic concentrations in the CNS, making it effective for treating meningitis.

Summary: The nurse should explain to the client that cefotaxime is prescribed because it can achieve therapeutic concentrations in the central nervous system, which is essential for effectively treating meningitis. Oral cephalosporins like cefaclor and cefadroxil do not reach adequate levels in the CNS and therefore are not suitable for this type of infection.