The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's diagnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Rationale: A. Begin the infusion and submit a drug reaction report to the nursing supervisor: Starting the infusion despite evidence of rising liver enzymes could worsen hepatotoxicity. Submitting a report is appropriate, but the immediate priority is preventing further harm. B. Hold the dose and notify the healthcare provider (HCP) of the changes in the laboratory studies: Fluconazole is metabolized in the liver and can cause hepatotoxicity. A rising AST level indicates possible liver injury, so the safest action is to withhold the drug and promptly inform the provider for further evaluation. C. Begin the infusion and monitor the client's blood urea nitrogen (BUN), serum creatinine, and liver function tests: While continued monitoring is essential, proceeding with the infusion despite worsening liver function exposes the client to further risk. D. Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: The pharmacy should only be contacted after the provider makes the decision to discontinue the medication. Stopping the infusion and notifying the provider first ensures that clinical judgment guides changes in therapy.