Chapter 42 pharm
A patient who is receiving treatment for systemic mycoses complains of pain and abnormal sensation in the feet. Which antifungal drug does the nurse expect to find in the prescription?
Amphotericin B
Which antifungal drug is available in injectable, oral, and topical preparations?
Amphotericin B
Which is the antifungal drug of choice for the treatment of many severe systemic fungal infections?
Amphotericin B
What is the most appropriate antifungal agent for treating a patient with an aspergillosis lung infection?
Itraconazole
What should the nurse do before administering intravenous (IV) amphotericin B?
Administer an antipyretic, antihistamine, and antiemetic as prescribed.
Which fungi, found in bird droppings, can cause infection in the meninges covering the human brain?
Cryptococcus
Which antifungal drug is contraindicated during pregnancy?
voriconazole
Which antifungal drug may cause hallucinations?
voriconazole
A patient with athlete's foot asks the nurse about the pathogenesis of fungal infections. What should the nurse include in the response? Select all that apply.
"Fungi can grow on skin and nails." "Fungal infection may manifest as a mild illness." "Severe systemic fungal infections occur in immunocompromised people."
A patient is being treated with intravenous amphotericin B. What is the nurse's priority intervention?
Assess blood urea nitrogen and creatinine.
Which antifungal drug is prescribed to a patient with invasive aspergillosis who does not tolerate or respond to other drugs?
Caspofungin
Which is the most common factor that contributes to the many drug interactions with antifungal agents?
Cytochrome P-450 enzyme system
What treatment should the nurse expect to administer to a patient who has been diagnosed with vaginal candidiasis?
Fluconazole, one tablet by mouth
What antifungal drug is prescribed to children in units rather than in milligrams and is not dosed based on the child's weight?
Nystatin
A nurse has a sample of the medicine nystatin. Which type of patient will receive this medication?
Patients with oral candidiasis infection
While assessing a patient who began treatment with an antifungal drug 1 week earlier, the nurse notes an interval weight gain of 6 pounds. Upon notifying the primary health care provider of this change, what diagnostic testing should the nurse anticipate?
Serum blood urea nitrogen and creatinine levels
Which form of the antifungal drug terbinafine is used primarily to treat onychomycoses of the fingernails or toenails?
Tablet
A patient is diagnosed with an oral candida infection. Which intervention will the nurse expect to implement?
Teach the patient how to take nystatin.
Which antifungal drug is most likely to cause alopecia when given at high doses to treat an infection involving the nails?
Terbinafine
What is the appropriate drug, dose, route, and duration to treat a patient diagnosed with onychomycosis of the toenail?
Terbinafine 250 mg by mouth daily for 12 weeks
Why is the lipid dosage form of amphotericin B used only when patients are intolerant to nonlipid amphotericin B?
The lipid dosage form of amphotericin B is costly.
The nurse is preparing to administer intravenous amphotericin B. Which administration technique should the nurse follow to minimize infusion-related adverse effects?
Use a longer-than-average drug infusion time.
In what anatomic region(s) in human beings can fungi be found as part of the normal flora? Select all that apply.
Vagina, intestines
How can the nurse determine whether a patient will tolerate an amphotericin B infusion?
administer a test dose
Which antifungal drug acts by binding to key structures known as microtubules, thus inhibiting fungal mitosis?
griseofulvin
A nurse is caring for a patient with invasive aspergillosis who is on caspofungin therapy. What parameters should the nurse monitor in this patient to prevent adverse drug reactions? Select all that apply.
heart rate liver enzymes WBC count
For which common adverse effect should the nurse monitor in a patient who receives intravenous amphotericin B?
hypotension
What is the common drug-induced adverse effect of caspofungin?
leukopenia
What patients are at risk for developing oral candidiasis (thrush)? Select all that apply.
newborns immunocompromised peoples
Which antifungal drug is applied topically for the treatment of candidal diaper rash?
nystatin
Which patients are susceptible to developing severe systemic fungal infections? Select all that apply.
patient recieving chemotherapy patient recieving immunosuppressives for lupus A patient who has acquired immune deficiency syndrome (AIDS)
The nurse is caring for a patient with systemic mycoses who is on amphotericin B. Which parameters should the nurse monitor for safe and effective care? Select all that apply.
potassium creatine BUN
Which drug does not cause a significant interaction when given to a patient receiving amphotericin B for a histoplasmosis infection?
potassium-sparing diuretic
Which precaution should the nurse follow while administering caspofungin to a patient with impaired liver function?
reducing the dose of caspofungin
A patient who is receiving an oral anticoagulant is started on fluconazole to treat a fungal infection. What possible drug interaction could occur in this patient?
risk of bleeding
What possible effect will the nurse anticipate in a patient who has received amphotericin B along with thiazide diuretics?
severe hypokalemia
What are the features of yeast that help to differentiate it from mold? Select all that apply.
single-celled reproduces by budding
What are the common primary tissues that are affected by infection with the Trichophyton spp.? Select all that apply.
skin scalp
The nurse is caring for a patient who was prescribed nystatin lozenges for oral candidiasis. What instruction should the nurse give to ensure effective medication administration?
slowly and completely dissolve lozenges in mouth
