The charge nurse is working with a student nurse who reports that her assigned client has severe flushing of the upper body following an IV antibiotic infusion. The charge nurse understands that the antibiotic likely responsible for this “red man syndrome” is which medication?

  1. cephalexin
  2. amoxicillin
  3. gentamicin
  4. vancomycin
Number 4 is correct.
Rationale: Upper body flushing, often called “red man syndrome,” is a side effect of vancomycin that can occur especially if the drug is infused too rapidly. Side effects of cephalexin include diarrhea, easy bruising, dark urine, and joint pain. Side effects of amoxicillin include black or “hairy” tongue, stomach pain, nausea and vomiting, and pale or yellowed skin. Side effects of gentamicin include loss of appetite, rash, increased thirst, and muscle twitching. Side effects of antibiotics may be minor, severe, or life-threatening.