Clinical context A 56-year-old with invasive aspergillosis is being evaluated before isavuconazonium is started; the nurse reviews cardiac, hepatic, allergy, and medication histories. Which history should cause the nurse to question an isavuconazonium prescription?

1 Prior fluconazole-associated nausea without hypersensitivity
2 Mild stable aminotransferase elevation with a prescribed monitoring plan
3 Previously corrected hypokalemia with a normal current electrocardiogram
4 Familial short-QT syndrome ✓ Correct answer

Explanation

Isavuconazole shortens the QT interval and is contraindicated in familial short-QT syndrome. It also has important strong CYP3A4 interaction restrictions.

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In-depth explanation

Quick answer
Unlike many azoles, isavuconazole can shorten QT.

Why this is correct
The direction of the QT effect is clinically important and makes familial short-QT syndrome a specific contraindication.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.

References

1DailyMed: CRESEMBA (isavuconazonium sulfate)QT shortening and familial short-QT contraindication

Clinical scenario

Clinical context
A 56-year-old with invasive aspergillosis is being evaluated before isavuconazonium is started; the nurse reviews cardiac, hepatic, allergy, and medication histories.

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Clinical context A 56-year-old with invasive aspergillosis is being evaluated before isavuconazonium is started; the nurse reviews cardiac, hepatic, allergy, and medication histories. Which history should cause the nurse to question an isavuconazonium prescription?

In-depth explanation

Clinical scenario

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