Pharm 87-91
hich statement should the nurse include when teaching a patient about rifampin [Rifadin]? "A harmless side effect will be a red-orange discoloration of body fluids." "Oral contraception is the preferred method of birth control when using rifampin." "Take vitamin B6 to relieve numbness and tingling in the fingers and toes." "Treatment length for the medication is 3 times/day for an 8-week period."
"A harmless side effect will be a red-orange discoloration of body fluids." Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful. Rifampin does not cause peripheral neuropathy. It does reduce the effectiveness of oral contraceptives, so a nonhormonal form of birth control should be considered. All antitubercular agents need to be taken at least 6 to 24 months to eradicate the slow-growing mycobacterium.
A nurse is administering a daily dose of tobramycin at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level? 8:00 AM 9:00 AM 11:30 AM 12:00 AM
9 AM Trough levels determine the lowest level between doses. Blood is drawn just before the next dose is administered when a divided dose is used or 1 hour before the next dose if a single daily dose is used.
A patient who has active TB is to start a medication regimen that includes pyrazinamide. The nurse identifies a risk for complications if the patient also has which medical condition? Parkinson's disease Rheumatoid arthritis Glaucoma Alcoholism
Alcoholism Pyrazinamide is contraindicated in patients with both liver dysfunction and gout. It should be used with caution in patients who abuse alcohol, and liver function studies should be done every 2 weeks. It is not known to cause complications in patients who have Parkinson's disease, rheumatoid arthritis, or glaucoma.
Before administering trimethoprim, it is most important for the nurse to assess the patient for a history of what? Heart failure Alcoholism Diabetes Emphysema
Alcoholism Trimethoprim inhibits bacterial synthesis of folic acid. It is avoided in patients when folate deficiency is likely, such as in alcoholism, because bone marrow suppression may occur. Heart failure, diabetes, and emphysema are unrelated to adverse effects with trimethoprim.
A nurse obtains a specimen from which body fluid when performing the QuantiFERON-TB Gold (QFT-G) test for latent tuberculosis? Saliva Blood Urine Sputum
Blood The specimen for the QFT-G test is obtained from blood, not from saliva, urine, or sputum. It is a new test for latent TB and is as sensitive as the tuberculin skin test and more specific. The results are available within 24 hours, and unlike with the skin test, a follow-up visit to a healthcare provider's office is not required.
When administering an aminoglycoside to a patient with myasthenia gravis, it is most important for the nurse to assess what? Deep tendon reflexes Breath sounds Eyelid movement Muscle strength
Breath sounds Aminoglycosides can inhibit neuromuscular transmission, causing potentially fatal respiratory depression. Patients with myasthenia gravis (MG) are at an increased risk. Deep tendon reflexes, eyelid movement, and muscle strength are important assessments for a patient who has MG, but they are not as important as airway and breathing ability.
patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Slow the running pace and walk more. Discontinue the medication, because severe damage can result.
Discontinue the medication, because severe damage can result. Fluoroquinolones may result in tendinitis and rupture by disrupting the extracellular matrix of cartilage. Because tendon injury is reversible if diagnosed early, fluoroquinolones should be discontinued at the first sign of tendon pain or inflammation.
A patient who has acute cystitis is receiving treatment with trimethoprim/sulfamethoxazole. Which manifestation should indicate to a nurse that the patient's condition is worsening? Incontinence Flank pain 3+ pedal edema Hyperactive bowel sounds
Flank pain Flank pain may indicate continued infection or pyelonephritis. When acute cystitis is treated with a traditional agent of choice, such as trimethoprim/sulfamethoxazole, manifestations of dysuria, urinary urgency and frequency, suprapubic discomfort, and bacteriuria improve. Incontinence, 3+ pedal edema, and hyperactive bowel sounds are unrelated to acute cystitis.
Which approach should a nurse take when administering an oral dose of levofloxacin [Levaquin]? Give the medication with or without food. Administer the drug with an oral dose of a magnesium-based antacid. Premedicate the patient with diphenhydramine [Benadryl]. Administer the drug with milk products.
Give the medication with or without food. Levofloxacin should not be administered with milk products or antacids containing magnesium or aluminum, because this reduces absorption from the gastrointestinal (GI) tract. However, this does not happen with most foods. Premedicating with diphenhydramine is unnecessary.
A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin? White blood cells (WBCs) Glucose Ketones Protein
Protein Aminoglycoside-induced nephrotoxicity usually presents as acute tubular necrosis. Symptoms of concern are protein in the urine, dilute urine, and elevation of the serum creatinine and blood urea nitrogen (BUN) levels. WBCs, glucose, and ketones are not specifically related to gentamicin use.
The nurse identifies which statements about frequent urinary tract reinfections as true? (Select all that apply.) Reinfections are considered frequent if the individual has three or more a year. Prophylactic therapy should continue for at least 2 months. If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. Single-dose nitrofurantoin 50 mg taken 1 hour before intercourse has been found to reduce the rate of reinfection. If a symptomatic episode occurs, the standard therapy for acute cystitis should be used
Reinfections are considered frequent if the individual has three or more a year. Prophylactic therapy should continue for at least 2 months. If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. If a symptomatic episode occurs, the standard therapy for acute cystitis should be used Prophylactic therapy should continue for at least 6 months. Single-dose trimethoprim/sulfamethoxazole, taken after intercourse, has been found to reduce the risk of reinfection. The other three statements are true.
To promote treatment adherence in a patient with tuberculosis, the nurse will include which interventions? (Select all that apply.) Use a single medication, to keep the treatment simple. Teach the patient about intermittent-dose therapy. Teach the patient about the need for long-term treatment. Use a signed consent form to enhance patient compliance. Directly watch the patient take the medication.
Teach the patient about intermittent-dose therapy. Teach the patient about the need for long-term treatment. Directly watch the patient take the medication.
Which statements about ototoxicity and aminoglycosides does the nurse identify as true? (Select all that apply.) The risk of ototoxicity is related primarily to excessive peak levels. The first sign of impending cochlear damage is headache. The first sign of impending vestibular damage is headache. Correct Ototoxicity is largely irreversible. Correct Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity. Correct
The first sign of impending vestibular damage is headache ototoxicity is largely irreversible use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity The risk of ototoxicity with aminoglycoside use is related primarily to excessive trough levels. The first sign of impending vestibular damage is headache. The first sign of cochlear damage is tinnitus. The other two statements are true.
The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? Concentration Trough Peak Dose
When trough levels remain elevated, aminoglycosides are unable to diffuse out of inner ear cells, thus exposing the cells to the medication for an extended time. Prolonged exposure (ie, high trough levels), rather than brief exposure to high levels, underlies cellular injury.
The nurse is aware that acute cystitis occurs most often in which patient population? Older-adult male patients Children younger than 12 years Women of child-bearing age Women older than 50 years
women of childbearing age
With the exception of pyelonephritis, the nurse is aware that most urinary tract infections are treated by which method? IV antibiotics at the hospital IV antibiotics in the urgent care setting IM antibiotics at the primary physician's office Oral antibiotics in the home setting
Oral antibiotics in the home setting
Which statement by a patient taking ethambutol [Myambutol] indicates understanding of adverse effects of the drug? "I will get up slowly when sitting to prevent me from getting dizzy." "I'll increase the fiber and liquids in my diet to prevent constipation." "I'll report any problems with blurred vision or determining colors."
"I'll report any problems with blurred vision or determining colors." Ethambutol can cause optic neuritis, resulting in disturbance of color discrimination and blurred vision. Symptoms resolve when the medication is discontinued. Orthostatic hypotension, constipation, and discoloration of urine are not known adverse effects of ethambutol. "I'll immediately report any red-orange urine to my healthcare provider."
When teaching a patient about tuberculosis, the nurse will include which statements? (Select all that apply.) "Most people infected with M. tuberculosis are asymptomatic." "Most people infected with M. tuberculosis harbor dormant bacteria for life if they do not receive drug therapy." "Treatment of tuberculosis lasts 3 months." "Isoniazid can cause peripheral neuropathy by depleting vitamin B12." "Rifampin can cause optic neuritis."
"Most people infected with M. tuberculosis are asymptomatic." "Most people infected with M. tuberculosis harbor dormant bacteria for life if they do not receive drug therapy."
Which statements will the nurse include when teaching a patient about isoniazid therapy for the treatment of tuberculosis? (Select all that apply.) "Take the isoniazid on an empty stomach." Correct "Notify your healthcare provider if your skin starts to turn yellow." Correct "Numbness or tingling in your extremities is a normal response when taking this drug." "Your urine will turn reddish orange because of the effects of this drug." "Use of this drug is associated with vision problems."
"Take the isoniazid on an empty stomach." "Notify your healthcare provider if your skin starts to turn yellow."
he healthcare provider orders levofloxacin [Levaquin] 500 mg PO every day for 7 days. The available medication is levofloxacin 250-mg tablets. How many tablets should the patient take each day? 0.5 tablet 1 tablet 1.5 tablets 2 tablets
2 tablets Two tablets that are each 250 mg would equal the ordered 500-mg daily dose.
A patient who has human immunodeficiency virus (HIV) infection has a tuberculin skin test (TST) for latent tuberculosis. The nurse assesses the result 48 hours after the injection. An induration of what size indicates that the patient needs to be treated for latent tuberculosis? 1 mm 2 mm 3 mm 5 mm
5 mm A positive reaction on the TST is indicated by an area of induration (hardness) around the injection site. The decision to treat latent tuberculosis is based on the risk category and size of the induration area. Treatment is recommended in high-risk individuals, such as those with HIV infection, for an induration of 5 mm. An induration of 10 mm is required to treat moderate-risk individuals. An induration of more than 15 mm is required to treat low-risk individuals.
A patient taking gemifloxacin develops a rash. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Cut the dose of medication in half. Discontinue the medication.
Discontinue the medication The incidence of rash with gemifloxacin is much higher than with other fluoroquinolones. Women under 40 years of age are at greatest risk. Symptoms are severe in about 10% of patients who develop a rash; in the rest, symptoms are mild to moderate. As a rule, gemifloxacin-induced rash resolves spontaneously in 1 to 2 weeks, although some patients require treatment with systemic glucocorticoids. If rash develops, gemifloxacin should be discontinued.
A patient is taking nitrofurantoin [Macrodantin]. Which finding should a nurse recognize as an indication that the treatment is having an undesired effect? Hyperpigmentation of the palms Dyspnea with chills Gum irritation with bleeding Scalp tenderness and thinning hair
Dyspnea with chills Nitrofurantoin, a urinary tract antiseptic, may induce a pulmonary reaction that manifests with dyspnea, chest pain, and chills. These symptoms, which resolve 2 to 4 days after the drug is stopped, are thought to be hypersensitivity reactions. Hyperpigmentation of the palms, gum irritation with bleeding, and scalp tenderness and thinning hair are not side effects associated with nitrofurantoin.
Most cases (more than 80%) of uncomplicated, community-acquired urinary tract infection (UTI) are caused by which bacteria? Klebsiella pneumoniae Escherichia coli Enterobacter spp. Pseudomonas spp.
Escherichia coli Most cases of uncomplicated, community-acquired UTI are caused by E. coli. In rare cases, other gram-negative bacilli (eg, K. pneumoniae, Enterobacter spp., and Pseudomonas spp.) are the cause.
The nurse is working with a patient who has a UTI. Because patient adherence to a medication regimen is a concern, the nurse anticipates use of which medication? Fosfomycin Amoxicillin Cephalexin Trimethoprim
Fosfomycin When adherence is a concern, fosfomycin, which requires just one dose, is an attractive choice. As a rule, amoxicillin and cephalexin are avoided, because they are less effective than the alternatives and are less well tolerated. Trimethoprim requires a longer course of therapy than fosfomycin.
A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? Unsteadiness Vertigo Headache Dizziness
Gentamicin causes irreversible ototoxicity, which results in both impaired hearing and disruption of balance. Headache is the first sign of impending vestibular damage (balance) and may last 1 to 2 days. Unsteadiness, vertigo, and dizziness appear after headache.
A nurse assesses the history of a patient who has had multiple complicated UTIs for which risk factors? (Select all that apply.) Female gender, child-bearing age Indwelling catheter Prostate hypertrophy Fair skin tone Urinary tract stones
Indwelling catheter Correct Prostate hypertrophy Correct Urinary tract stones
The nurse develops a care plan for a patient in the continuation phase of treatment for active tuberculosis (TB). The care plan includes teaching about which medication regimen? Pyrazinamide and ethambutol Isoniazid and rifampin Ethambutol and isoniazid Rifampin and ethambutol
Isoniazid and rifampin If drug resistance is not a factor, treatment for active TB consists of a four-drug induction phase and a two-drug continuation phase. The continuation phase lasts at least 4 months, and therapy consists of two drugs—isoniazid and rifampin. Pyrazinamide and ethambutol, ethambutol and isoniazid, and rifampin and ethambutol are not the preferred regimens for the continuation phase.
Which outcomes should a nurse establish when planning care for a patient taking methenamine [Mandelamine]? (Select all that apply.) Maintains a urine pH of 5.5 or lower. Consumes 3000 mL of liquid daily. Uses an enteric-coated formulation. Avoids sulfonamide medications. No elevation in liver enzymes.
Maintains a urine pH of 5.5 or lower. Uses an enteric-coated formulation. Avoids sulfonamide medications. Under acidic conditions, methenamine makes formaldehyde, which causes bacterial cell death. Formaldehyde requires an acid urine to be released. To prevent the dose from being converted to formaldehyde in an acidic stomach, an enteric-coated formula may be used. Ingestion of large volumes of fluid dilutes methenamine and raises the urinary pH. Hepatotoxicity is not associated with methenamine [Mandelamine].
Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what? Myasthenia gravis Asthma Hypertension Diabetes mellitus
Myasthenia gravis In general, aminoglycosides are poorly absorbed in the gastrointestinal (GI) tract. Neomycin is given orally to suppress bowel flora before surgery of the intestine and is not used parenterally because of its high nephrotoxicity and ototoxicity. Gentamicin, tobramycin, and amikacin are administered parenterally only.
Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery? Gentamicin Tobramycin Amikacin Neomycin
Neomycin In general, aminoglycosides are poorly absorbed in the gastrointestinal (GI) tract. Neomycin is given orally to suppress bowel flora before surgery of the intestine and is not used parenterally because of its high nephrotoxicity and ototoxicity. Gentamicin, tobramycin, and amikacin are administered parenterally only.
A patient taking a sulfonamide is breast-feeding an infant. Which complication in the infant would the nurse associate with kernicterus? Hemolytic anemia Neurologic deficits Hepatocellular failure Ophthalmic infection
Neurologic deficits Kernicterus is a disorder in newborns caused by deposition of bilirubin in the brain, which leads to severe neurologic deficits and death. Sulfonamides promote kernicterus by displacing protein-bound bilirubin from the proteins, leaving newly freed bilirubin access to brain sites. Sulfonamides are not administered to infants under 2 years old, nor are they given to pregnant patients near term or nursing mothers. Hemolytic anemia, hepatocellular failure, and ophthalmic infection are not associated sulfonamide effects in infants.
The nurse identifies which statements about Stevens-Johnson syndrome as true? (Select all that apply.) Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Short-acting sulfonamides do not induce Stevens-Johnson syndrome. Patients with Stevens-Johnson syndrome usually are hypothermic. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.
Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.
A patient who has acquired immunodeficiency syndrome (AIDS) is receiving trimethoprim/sulfamethoxazole [Bactrim]. Which response should a nurse expect if the medication is achieving the desired effect? Increase in CD4 T cells Increased appetite and weight gain Resolution of pneumonia Decrease in joint pain
Resolution of pneumonia Trimethoprim/sulfamethoxazole is the treatment of choice for Pneumocystis pneumonia (PCP), an infection caused by Pneumocystis jirovecii (formerly thought to be Pneumocystis carinii). PCP is an opportunistic pneumonia caused by a fungus that thrives in immunocompromised hosts. It does not increase the number of CD4 T cells, the targeted cells of the human immunodeficiency virus (HIV), nor does it affect joint pain. Increased appetite and weight gain are not therapeutic actions of trimethoprim/sulfamethoxazole.
After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant? The patient takes antacids on a daily basis. The medication was stored in a cool, dry area. The patient did not use sunscreen while taking the ciprofloxacin [Cipro]. The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.
The patient takes antacids on a daily basis. Antacids interfere with the absorption of quinolone antibiotics, such as ciprofloxacin [Cipro], and many other drugs; therefore, this patient has not received the full dosing regimen, which is required if ciprofloxacin is to be effective against the infection. Storing the drug in a cool, dry area and using sunscreen or diphenhydramine would not disrupt the effectiveness of ciprofloxacin.
The nurse identifies rifampin as useful in the treatment of which disorders? (Select all that apply.) Tuberculosis Active meningococcal infection Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae C. difficile infection
Tuberculosis Leprosy Prophylaxis of meningitis caused by H. influenzaw
When providing patient teaching for oral sulfonamide therapy, the nurse should instruct the patient to take the sulfonamide in what way? At mealtime, when food is available With soy or nonmilk products Between meals with a full cup of water On awakening before breakfast
between meals with a full cup of water Oral sulfonamides should be taken on an empty stomach and with a full glass of water. To minimize the risk of renal damage, adults should maintain a daily urine output of 1200 mL. Sulfonamides should not be taken with soy or nonmilk products or food or before breakfast without liquids.
A patient is taking rifampin [Rifadin] for active tuberculosis. Which assessment does the nurse identify as an adverse effect of the drug? Jaundice Blood glucose level of 60 mg/dL Absent deep tendon reflexes Moon face
jaundice Rifampin is toxic to the liver, which increases the patient's risk of hepatitis. Jaundice is a sign of liver dysfunction and should be monitored. Rifampin has no effect on the blood glucose level or deep tendon reflexes, nor does it cause a moon face.
A patient is taking daptomycin [Cubicin]. The nurse should obtain a creatine phosphokinase (CPK) level when the patient shows what? Increased urination and urinary urgency Muscle pain and weakness Abdominal bloating and diarrhea Headache and visual disturbances
muscle pain and weakness Daptomycin is one of the cyclic lipopeptides, a class of antibiotics that can kill gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). It may pose a small risk of myopathy (muscle injury). Patients should be warned about muscle injury and told to report any pain or weakness. In addition, CPK levels should be measured weekly. Increased urination and urinary urgency, abdominal bloating and diarrhea, and headache and visual disturbances are not associated with daptomycin.
A patient who has tuberculosis is treated with isoniazid. The nurse should monitor for which symptoms, which could indicate a vitamin B6 deficiency caused by the medication? Numbness and tingling in the fingers and toes Alopecia and flaking scalp Dry skin and brittle nails Oral ulcers and tongue fissures
numbness and tingling in the fingers and toes Dose-related peripheral neuropathy is the most common adverse effect of isoniazid. It results from a vitamin B6 deficiency, which is corrected by taking oral supplements. Symptoms include numbness and tingling in the fingers and toes. Alopecia and flaking scalp, oral ulcers and tongue fissures, and dry skin and brittle nails are not adverse effects of isoniazid-induced vitamin B6 deficiency.
A patient who has an infection with Mycobacterium leprae (leprosy) has been prescribed rifampin [Rifadin]. The nurse identifies which dosing schedule as most effective for this drug? Two times per day Every other day Once every 2 weeks Once per month
once per month Rifampin is the most effective agent for treating leprosy. A single dose kills more than 99.9% of viable M. leprae. Monthly administration is effective, and this dosing schedule minimizes adverse effects.
A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? Some hearing loss may have occurred The confusion is due to the hospital stay. A nutrition consult most likely is needed. The patient has a family history of dementia.
some hearing loss may have occurred The patient's comment suggests that the person did not hear the instructions. Aminoglycoside antibiotics can cause ototoxicity. The first sign may be tinnitus (ringing in the ears), progressing to loss of high-frequency sounds. Audiometric testing is needed to detect it. Nutrition, confusion, and a family history of dementia do not address the problem of possible hearing loss associated with aminoglycosides.
The nurse notices tan lines around the arms of a female patient who is taking levofloxacin [Levaquin]. Which action should the nurse take? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Advise the patient to avoid sun exposure and wear sun screen when outside. Discontinue the medication.
Advise the patient to avoid sun exposure and wear sun screen when outside. Fluoroquinolones pose a risk of phototoxicity. Accordingly, patients should avoid sunlight and sunlamps, and should use protective clothing and a sunscreen if they must go outdoors.
The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients? Metronidazole [Flagyl] Rifampin [Rifadin] Ciprofloxacin [Cipro] Daptomycin [Cubicin]
Ciprofloxacin In elderly patients, ciprofloxacin [Cipro] poses a significant risk of confusion, somnolence, psychosis, and visual disturbances. Metronidazole, rifampin, and daptomycin are not associated with confusion in elderly patients.
A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse anticipates administration of which antibiotic if a stool sample tests positive for Clostridium difficile? Rifaximin [Xifaxan] Metronidazole [Flagyl] Daptomycin [Cubicin] Gemifloxacin [Factive]
Metronidazole Metronidazole is the treatment of choice for antibiotic-associated colitis caused by C. difficile. Rifaximin, daptomycin, and gemifloxacin are not used in the treatment of C. difficile infection.
A patient is to begin taking nitrofurantoin [Macrodantin]. The nurse should teach the patient that which manifestation should be the priority to report to the healthcare provider? Headache and drowsiness Brown-colored urine Nausea and vomiting Muscle weakness and tingling
Muscle weakness and tingling Nitrofurantoin is used in acute infections of the lower urinary tract only. Muscle weakness and tingling may indicate irreversible damage to sensory and motor nerves caused by demyelinization of nerves. Patients should be informed of these symptoms and taught to report them immediately. Gastrointestinal (GI) effects may be minimized by taking the drug with milk or food. Brown urine is a harmless effect of the urinary excretion of the medication. Headache and drowsiness are less common adverse effects that are readily reversible.
A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? Magnesium sulfate [Epsom salt] Potassium chloride [K-Dur] Sodium bicarbonate [Citrocarbonate] Calcium gluconate [Kalcinate]
calcium gluconate Flaccid paralysis and impaired breathing are signs of impaired neuromuscular transmission, which may occur with aminoglycosides, especially if they are administered concurrently with a neuromuscular blocking agent. Impaired transmission can be reversed with intravenous infusion of a calcium salt (calcium gluconate). Magnesium sulfate, potassium chloride, and sodium bicarbonate do not reverse impaired neuromuscular transmission caused by aminoglycosides.
The nurse is assessing a patient who is receiving a sulfonamide for treatment of a urinary tract infection. To monitor the patient for the most severe response to sulfonamide therapy, the nurse will assess for what? Diarrhea Skin rash and lesions Hypertension Bleeding
skin rash and lesions The nurse's priority is to monitor for hypersensitivity reactions. The most serious response to sulfonamide therapy is Stevens-Johnson syndrome, which manifests as symptoms of the skin and mucous membranes, lesions, fever, and malaise. In rare cases, hematologic effects occur, requiring periodic blood studies.