A nurse is caring for a client who has a new prescription for cefazolin. Which of the following findings should the nurse identify as a contraindication to the administration of cefazolin?

This client is scheduled for an appendectomy and has a new order for cefazolin. Cefazolin is a first-generation cephalosporin antibiotic. Nursing practice requires careful screening of medication orders against patient allergies to prevent severe, life-threatening hypersensitivity reactions before administration. Choice A rationale: A white blood cell count of 13,000 per cubic millimeter is elevated above the 5,000 to 10,000 range, which is an expected clinical finding in appendicitis, reflecting an active inflammatory and infectious process, not a contraindication to antibiotic therapy. Choice B rationale: An amylase level of 80 units per liter is within the normal range of 60 to 120 units per liter. This result is normal and provides no clinical information that would contraindicate the administration of the prescribed cephalosporin antibiotic. Choice C rationale: A temperature of 38.5 degrees Celsius is an expected manifestation of acute appendicitis. Fever indicates an infection, which is the primary reason the provider prescribed the antibiotic to control the bacterial process; it is not a contraindication to treatment. Choice D rationale: While the client has a history of hypertension, a prescription for furosemide is not listed in the provided patient history or medication record. Regardless, there is no inherent contraindication between cephalosporin antibiotics and standard antihypertensive or diuretic medication classes. Choice E rationale: The client has a severe penicillin allergy. Because cephalosporins have a similar chemical structure to penicillins, there is a risk of cross-reactivity. This allergy history is a significant contraindication, and the nurse must notify the provider before administering the medication.