A nurse is providing teaching to an adolescent who has a new prescription for cefazolin. For which of the following adverse effects should the nurse instruct the adolescent to monitor and report to the provider?

Choice A rationale Dry mouth, or xerostomia, is not a common or expected adverse effect of cefazolin, which is a first-generation cephalosporin antibiotic. Adverse effects of cephalosporins are more commonly gastrointestinal, such as nausea and diarrhea, or hypersensitivity reactions. Dry mouth is more frequently associated with anticholinergic drugs or certain other medication classes. Choice B rationale Constipation is not a typical adverse effect associated with cefazolin. Cephalosporin antibiotics, like many other antibiotics, can disrupt the normal gut flora (microbiome), which more often leads to diarrhea. Diarrhea, sometimes severe and caused by Clostridioides difficile, is a known gastrointestinal side effect, but constipation is generally not a recognized concern. Choice C rationale Back pain is not a known or common adverse effect of cefazolin. Adverse effects of this antibiotic are typically related to the gastrointestinal system, the hematological system (e.g., leukopenia), or hypersensitivity reactions. Back pain is a non-specific symptom that is not directly attributable to the pharmacological action or known side effect profile of cefazolin. Choice D rationale Cefazolin is a beta-lactam antibiotic, a class of drugs that can cause hypersensitivity reactions. Urticaria, also known as hives, is a common manifestation of a type I hypersensitivity reaction, which involves the release of histamine from mast cells and basophils. This is a potentially serious adverse effect that the adolescent should monitor for and report immediately to the healthcare provider.