A 67 year old female patient presents to the clinic with a chief complaint of catbite to her left thumb which occurred 3 days ago.
A 67 year old female patient presents to the clinic with a chief complaint of catbite to her left thumb which occurred 3 days ago. Her thumb is red, swollen, and the patient reports pain 9 out of 10. She states she went to the ED at the time and was prescribed Amoxicillin/clavulanate 875 mg BID. The pain, however is much worse now and her thumb is so swollen she cannot bend it. She has also been having chills. VS: BP 132/88, P 104, RR 16, T- 100.7 PMH: CAD with cardiac stents placed 6 years ago What is the NPs next best plan of action: Group of answer choices immediate referral to the health department for the rabies vaccine consult the hospitalist for admission disccontinue the augmentin-clavulinate as it is not working and start doxycycline 100 mg PO BID give an IV dose of vancomycin in the office now and have her return tomorrow for a recheck
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