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

A. Presence of gram positive bacteria in the sputum: Piperacillin/tazobactam is a broad-spectrum antibiotic effective against many gram-positive and gram-negative organisms. The presence of gram-positive bacteria alone does not contraindicate its use and would not require withholding the medication. B. Elevated white blood cell count: An elevated WBC count is a common finding in pneumonia and indicates an active infection. This supports the need for antibiotic therapy and does not warrant holding the medication. C. Elevated cholesterol and lipoproteins: High lipid levels are unrelated to piperacillin/tazobactam administration and do not affect its dosing or safety profile. These findings would not require delaying treatment. D. Decreased creatinine clearance: Piperacillin/tazobactam is excreted primarily by the kidneys, and impaired renal function increases the risk of drug accumulation and toxicity. Dosage adjustment is necessary in renal impairment, so this finding should be reported before administration.