Pharm ch 22 - prepu questions

You are teaching your 82-year-old client about amphotericin B, an antifungal ordered by his physician. Which of the following client statements would suggest that your teaching has been effective?

"Taking this drug could damage my kidneys." Amphotericin B is nephrotoxic. Because of this, the drug is used ONLY for serious fungal infections.

A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

"The medication may cause kidney damage." The main concern with the administration of amphotericin B is the risk of nephrotoxicity. Thus, the statement that the medication may cause kidney damage is the most appropriate. The medication will not cause diabetes, liver necrosis, or pancreatitis.

You are caring for a patient who is receiving amphotericin B. Which of the following medications could you administer concomitantly to promote patient comfort?

Antipyretics Amphotericin B is a highly toxic drug with adverse effects than include fever, chills, anorexia, nausea, and vomiting. Antipyretics and antiemetics may be given to reduce these effects and improve patient comfort.

The following statement by 82-year-old Mr. B. leads you to believe that he has understood the teaching that you have done regarding amphotericin B (Fungizone). He says he could develop which of the following?

Damage to his kidneys Amphotericin B is nephrotoxic. Amphotericin B does not cause diabetes, liver necrosis, or pancreatitis.

A 65-year-old patient in your unit is receiving immunosuppressive drug therapy following liver transplant. The patient's husband visits frequently, bringing her gifts each time. Which of the following gifts should you not allow?

Flowering plants Nurses should limit the exposure of immunocompromised patients to environmental fungi. Since potentially dangerous fungi may be present in soil, plants that contain soil should not be allowed in the patient's room.

A woman is seen in the clinic for vaginal itching and discharge. Which of the following medications can be administered in a single dose to treat her discomfort and vaginal discharge?

Fluconazole (Diflucan) Fluconazole (Diflucan) is used for vaginal candidiasis in a single oral dose of 150 mg.

Which drug is most commonly used orally to treat infections caused by Candida albicans?

Fluconazole (Diflucan) The azoles, are a large group of antifungals used to treat systemic and topical fungal infections (Table 11.1). The azoles include fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), terbinafine (Lamisil). and voriconazole (Vfend). Although azoles are considered less toxic than some other antifungals, such as amphotericin B, they may also be less effective in very severe and progressive infections.

Your client has a history of deep vein thrombosis, for which he is taking Coumadin. When providing patient education for this client, who is now taking fluconazole to treat a localized candidal infection, you would include which of the following instructions?

Fluconazole increases the effects of warfarin. Have routine lab tests done. Fluconazole increases the effects of several drugs, including cyclosporine, phenytoin, oral sulfonylureas, and warfarin, but has fewer interactions than ketoconazole and itraconazole.

Amphotericin B is given by which route?

IV Amphotericin B and flucytosine are available in IV form.

The pharmacology students are learning about amphotericin B. This drug can be administered via which of the following routes?

IV Amphotericin B can be given intravenously. It is not administered via the subcutaneous or intramuscular routes.

Which statement would be correct for a patient regarding the administration of an antifungal medication?

Instruct the patient to complete the entire drug therapy even if a dose is missed. Any patient who is prescribed an antiviral or an antifungal drug needs to be advised to complete the entire drug therapy religiously and not to miss any drug dose. However, he or she need not take the missed dose if it is already time for the next dose. Patients should be informed that they should seek the advice of the prescriber if they experience any adverse effects such as redness, headache, swelling, or an aggravated lesion on the body. Patients should be advised to remain well hydrated throughout the therapy and not take heavy, fatty meals but light and frequent meals if they suffer from GI distress

Mr. Minor has been placed on amphotericin B. As the nurse caring for Mr. Minor, how will you be administering this medication?

Intravenously Amphotericin B is no longer administered orally; the most common route of administration is IV though intrathecal administration is used when fungus exists in the CSF.

You are treating a patient for a systemic fungal infection with an oral fungicide. What would be an important nursing action for you to perform?

Order dietary consultation as needed to ensure nutritional status Monitor nutritional status and arrange a dietary consultation as needed to ensure nutritional status. Putting foot rails up is not important, restraints are inappropriate, and offer six small meals daily if GI upset occurs.

The nurse is administering an antifungal medication. What is the most important health-related assessment required for the patient taking this medication?

Renal and hepatic dysfunction test Renal and hepatic dysfunction tests are the most common health-related assessments that need to be done for all patients taking antifungal and antiviral drugs. Other routine tests include CBC and, in specific cases, neurologic or ophthalmologic examinations. HIV tests need not be done for such patients.

You have admitted a 25-year-old female to your unit. What would be the most important for you to know before this patient begins systemic antifungal agents?

Renal and hepatic function It would be important for the nurse to know the patient's CBC, blood glucose level, eating and sleeping habits, and height and weight. All of these factors could help determine a specific drug and dosage. However, the most important factor would be the patient's renal and hepatic function to be able to assess for possible drug toxicity during drug therapy.

A patient has been administered amphotericin B. Which of the following adverse effects should the nurse closely monitor this patient for?

Renal impairment Renal damage is the most serious adverse reaction to the use of amphotericin B and should be closely monitored for. Conditions such as CNS disorders, skin discoloration, and weight loss are not known to be the common adverse effects of amphotericin B.

Ms. Jones, 64 years old, is placed on IV amphotericin B for a systemic fungal infection. Part of your care involves the development of a nursing plan of care. You identify the following nursing problem: ineffective protection related to drug-induced leukopenia and thrombocytopenia. What would be the most appropriate goal for this patient?

The patient will remain free from nosocomial infections during the hospital stay. Based on the problem identified, the most appropriate goal is that the patient will remain free from infection. When the nurse developed the plan of care, she identified ineffective protection due to leukopenia and thrombocytopenia, and the only goal that focuses on this aspect of care is for the patient to remain free from infection. The other goals focus on other side effects of the medication.

A topical antifungal cream should be gently rubbed into the affected area that has been washed with soap and water and patted dry. True or False?

True

During patient teaching the nurse instructs a patient who is taking an antifungal drug to report which of the following?

Unusual bruising and bleeding Unusual bruising and bleeding can be an indication of hepatic toxicity, which should be reported immediately. Yellowing of the eyes and not redness and watering indicates hepatic toxicity. Usually GI symptoms include nausea and vomiting with antiviral drugs, which could cause decrease appetite and weight loss.

Kate, 7 years old, is treated for oropharyngeal candidiasis. As the nurse preparing her for discharge, you teach the mother about the proper administration of nystatin. Which instruction will you emphasize?

Using the "swish and swallow" drug method The oral suspension of nystatin is administered by the method called "swish and swallow." The nurse should advise the patient to swish the solution throughout the mouth and then swallow or spit the drug out as directed by the prescriber. When nystatin troches are prescribed, advise the patient to allow them to dissolve completely in the mouth and not to chew or swallow the intact troche. The nurse should not pulverize the troche unless advised to do so by the prescriber for a child.

what is Warfarin?

is an anticoagulant normally used in the prevention of thrombosis and thromboembolism, the formation of blood clots in the blood vessels and their migration elsewhere in the body respectively.