On admission, the healthcare provider (HCP) prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

A. Complete blood count and serum electrolytes: These labs help monitor the client’s baseline health status and detect potential adverse effects of antibiotics, but they are not the most urgent step before the first dose. Cultures must be obtained first to guide targeted therapy. B. Irrigation and topical antibiotic application to wound area: While wound cleaning and topical treatment may help reduce surface bacteria, systemic infection requires systemic therapy. Additionally, this should not be done before obtaining cultures, as it could alter results. C. Wound and blood specimens for culture and sensitivity: Obtaining cultures before starting antibiotic therapy is critical to accurately identify the causative organism and determine the most effective antibiotic. Administering antibiotics before cultures can lead to false-negative results and delay optimal treatment. D. Monitor for signs of sodium and fluid retention: This is relevant for certain antibiotics, especially in clients with cardiac or renal issues, but it is part of ongoing monitoring. It is not the most urgent step before initiating therapy.