PHARM Quiz 6
Which side effect reported by the patient who is on an antibiotic therapy would be of high priority and require prompt notification to the primary health care provider? 1 "I have difficulty in breathing." 2 "I have trouble with digestion." 3 "I have giddiness upon standing." 4 "I have pain in the upper abdomen."
"I have difficulty in breathing." Respiratory distress is a serious side effect of antibiotic therapy due to anaphylaxis. It requires immediate intervention and prompt notification to the primary health care provider. Indigestion may also occur due to antibiotic therapy, but it may not require immediate intervention. Giddiness may also occur with antibiotic therapy, but it is not as important as that of an anaphylactic reaction. Abdominal pain can be treated based on its severity, but it is not of high priority and may not require immediate intervention.
The nurse is teaching precautions to a patient who is prescribed trimethoprim-sulfamethoxazole (Bactrim). Which statement of the patient indicates the need for additional teaching? A "I should report if bruising or bleeding occurs." B "I should use sunblock and wear protective clothing." C "I should take antacid to avoid gastrointestinal discomfort." D "I should drink more glasses of fluid while taking the medication."
"I should take antacid to avoid gastrointestinal discomfort." Antacids decrease the absorption of the sulfonamides such as trimethoprim-sulfamethoxazole (Bactrim) and hinder its therapeutic effects. Therefore, the nurse should provide further teaching and instruct the patient to avoid taking antacids while taking trimethoprim-sulfamethoxazole (Bactrim). Sulfonamides increase the risk of blood disorders in the patient. Therefore, in order to prevent these complications the patient should report if bleeding or bruising occurs. Using sunblock and wearing protective clothing prevent photosensitivity reactions in the patient. Increased water intake helps to prevent crystalluria, which is a side effect of trimethoprim-sulfamethoxazole (Bactrim).
What will the nurse teach a patient who is taking isoniazid (INH)? 1 "You will need to take vitamin C to potentiate the action of INH." 2 "You should not be on that drug. I will check with the health care provider." 3 "Pyridoxine (vitamin B6) will prevent numbness and tingling associated with taking isoniazid." 4 "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria."
"Pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid. Isoniazid (INH) can cause neurotoxicity. Pyridoxine (vitamin B6) is the drug of choice to prevent this adverse reaction. It is not an antiinfective agent and thus will work to destroy the mycobacterium or prevent drug resistance. Vitamin C is not taken with this drug; the drug is appropriate for most patients, and INH with pyridoxine is not multidrug therapy.
A primary health care provider prescribes an antacid to a patient who is taking ciprofloxacin (Cipro). What information will the nurse mention while counseling the patient? 1 "Take the antacid every alternate day." 2 "Take both drugs simultaneously." 3 "Take the drug on an empty stomach." 4 "Take the antacid 2 hours before the drug."
"Take the antacid 2 hours before the drug." The nurse should instruct the patient to take the antacid 2 hours before taking ciprofloxacin (Cipro) to improve the drug's absorption. The antacids should not be taken on alternate days because this may not help prevent gastrointestinal problems. Ciprofloxacin (Cipro) interacts with antacids, and this decreases the absorption of the ciprofloxacin (Cipro). Ciprofloxacin (Cipro) causes gastric irritation when administered on an empty stomach.
Which instruction will the nurse include in the discharge teaching for a patient receiving tetracycline? 1 "Take the medication until you feel better." 2 "Use sunscreen and protective clothing when outdoors." 3 "Keep the remainder of the medication in case of recurrence." 4 "Take the medication with food or milk to minimize gastrointestinal upset."
"Use sunscreen and protective clothing when outdoors." Photosensitivity is a common side effect of tetracycline. Exposure to the sun can cause severe burns. The medication should not be taken with milk and should be completely finished.
An adult patient says, "My children are being vaccinated. Are there any that I should have?" What is the nurse's correct reply? 1 "No, there are no vaccines that an adult needs." 2 "Yes, you need to stay up to date on several vaccines; check with your provider." 3 "Yes, you will need the same ones your children need." 4 "No, you have probably had all of the childhood diseases by now."
"Yes, you need to stay up to date on several vaccines; check with your provider." There are vaccines that adults need, but they are not all the same as childhood vaccines. Some childhood vaccines do need booster injections in adulthood.
The patient states that he or she has been prescribed prophylactic medication for tuberculosis for a period of 4 weeks. What is the nurse's best response? 1 "Let me teach you about the medications." 2 "We do not use medications prophylactically for tuberculosis." 3 "You should be on the drugs for at least 6 months." 4 "You should be on the medications for only 2 weeks."
"You should be on the drugs for at least 6 months." Between 6 months and 1 year is sufficient time for prevention of active tuberculosis. Because the tuberculosis mycobacterium is slow-growing, shorter lengths of time may not sufficiently eradicate the organism.
While instructing a patient about antibiotic therapy, the nurse explains to the patient that bacterial resistance to antibiotics can occur when what happens? Select all that apply. 1 Patients stop taking an antibiotic after they feel better. 2 Antibiotics are prescribed according to culture and sensitivity reports. 3 Antibiotics are prescribed to treat a viral infection. 4 Antibiotics are taken with water or juice. 5 Antibiotics are taken with ascorbic acid (vitamin C)
1 Patients stop taking an antibiotic after they feel better. 3 Antibiotics are prescribed to treat a viral infection. Not completing a full course of antibiotic therapy can allow bacteria that are not killed but have been exposed to the antibiotic to adapt their physiology to become resistant to that antibiotic. The same thing can occur when bacteria are exposed to antibiotics in the environment or when antibiotics are erroneously used to treat a viral infection.
A patient is given isoniazid (INH) to treat tuberculosis. Which adverse effects may occur in this patient? Select all that apply. 1 Yellowing of skin 2 Changes in vision 3 Changes in hearing 4 Tingling of extremities 5 Passing red-brown urine
1 Yellowing of skin 2 Changes in vision 4 Tingling of extremities Isoniazid (INH) is a first-line antitubercular drug. It causes jaundice because isoniazid (INH) is metabolized in the liver. If it is not completely metabolized it accumulates in the liver and causes jaundice and hepatotoxicity. Therefore, it is contraindicated in a patient who has hepatic injury. Isoniazid (INH) causes a drug-induced adverse effect of visual disturbances and results in optic neuritis. Isoniazid (INH) decreases the level of pyridoxine and results in tingling in the extremities. Therefore, a pyridoxine supplement is prescribed with isoniazid (INH). Changes in hearing and red-brown urine are not side effects of isoniazid (INH). Hyperuricemia is an adverse effect of pyrazinamide. Red-brown urine is an adverse effect rifampin (Rifadin), rifabutin (Mycobutin), and rifapentine (Priftin).
A patient on antibiotic therapy needs trough levels drawn. Which is the most appropriate time for the nurse to draw the trough level? 1 10 minutes before administration of the intravenous antibiotic 2 30 minutes after beginning administration of the intravenous antibiotic 3 60 minutes after completion of the intravenous antibiotic infusion 4 90 minutes after the intravenous antibiotic is scheduled to be administered
10 minutes before administration of the intravenous antibiotic Trough levels are drawn just before infusion. Peak serum drug levels should be drawn 30 to 60 minutes after the medication is infused. The nurse should document the time drug administration is started and completed and the exact time a peak and/or trough level is drawn.
The nurse educator is teaching a group of nursing students about immunity. Which points does the nurse emphasize while explaining passive immunity? Select all that apply. A "Passive immunity does not last for more than few months." B "Passive immunity can be achieved through the administration of toxoids." C "Passive immunity is useful to protect newborns from infections." D "Passive immunity activates the immune system to produce specific antibodies." E "Passive immunity is achieved by administering antibodies against infectious organisms."
A "Passive immunity does not last for more than few months." C "Passive immunity is useful to protect newborns from infections." E "Passive immunity is achieved by administering antibodies against infectious organisms." The effect of passive immunization is transient. It only lasts as long as the antibodies are present in the human system. Newborns have immature immune systems, and they passively acquire maternal antibodies through the placental barrier. Acquired passive immunity protects them from infections immediately after birth. Passive immunity occurs when an individual obtains antibodies against disease-causing microorganisms from another source. Toxoids are inactivated toxins which, when injected in the human body, activate the immune system to produce antibodies. This is a type of acquired active immunity. Passive immunity is obtained by administering antibodies into the human body. It does not involve activation of the immune system to produce specific antibodies.
A patient is prescribed trimethoprim-sulfamethoxazole (Bactrim). What instructions should the nurse give to the patient to ensure safe drug administration? Select all that apply. A "Wear sunglasses while going out." B "Take the medication one hour before meals." C "Take antacids along with the medication daily." D "Report the occurrence of bleeding immediately." E "Take the medication at night before going to sleep."
A "Wear sunglasses while going out." B "Take the medication one hour before meals." D "Report the occurrence of bleeding immediately." Sulfonamide medications such as trimethoprim-sulfamethoxazole (Bactrim) can cause photosensitivity in the patient and result in allergic reactions. Therefore, the patient should be advised to wear sunglasses while outdoors. Sulfonamides can cause gastric irritation. Therefore, the nurse should advise the patient to take the medication one hour before or after meals to prevent gastric irritation and also enhance the absorption of the drug. Sulfonamide may decrease the platelet count and cause excessive bleeding. Therefore, the patient should be advised to report the occurrence of bruising or bleeding immediately. Antacids decrease the absorption of sulfonamide; therefore, the patient should not take the medication along with antacids. Sulfonamides do not have any sedative effect; therefore, it is not necessary to take the medication before going to sleep.
What are common side effects of sulfonamides? Select all that apply. A Crystalluria B Hypokalemia C GI disturbances D Photosensitivity E Hyperglycemia
A Crystalluria C GI disturbances D Photosensitivity Crystalluria, GI disturbances, and photosensitivity are common side effects of sulphonamides. Sulfonamides are not soluble in urine and are eliminated in the form of crystals in the urine, which can result in crystalluria. They can increase the sensitivity of the skin, resulting in photosensitivity. A sulphonamide such as trimethoprim-sulfamethoxazole (Bactrim) increases potassium and insulin levels in the blood, resulting in hypokalemia and hyperglycemia. However, these are not common side effects.
The nurse is teaching the parents of a 1-year-old child about vaccinations. Which mild reactions are the parents likely to observe in the child a few hours after the administration of varicella vaccine? Select all that apply. A Fever B Pain at the injection site C Redness at the injection site D Bleeding at the injection site E Swelling at the injection site
A Fever B Pain at the injection site C Redness at the injection site The injection of varicella vaccine is likely to cause a child to develop fever. The vaccine also causes local inflammation, which may result in pain and redness at the injection site. Administration of varicella vaccine does not cause bleeding at the site of infection. Bleeding would occur only if the patient has a blood coagulopathy. Swelling at the injection site after administration of varicella vaccine is an abnormal sign and should be reported.
The nurse is caring for a patient with systemic infection who has been prescribed sulfadiazine (Microsulfon). The nurse gives 2000 mL of fluids daily to the patient. What is the rationale behind this intervention? Select all that apply. A To prevent crystalluria B To prevent constipation C To prevent hypovolemia D To prevent hypernatremia E To prevent kidney stones
A To prevent crystalluria E To prevent kidney stones Sulfadiazine (Microsulfon) is a sulfonamide drug. Sulfonamides are insoluble in acid urine and form crystals in the urine resulting in crystalluria and kidney stone formation. To decrease the pH of the urine and to prevent crystallization of the drug, the patient should intake at least 2000 mL of fluids daily. Sulfadiazine (Microsulfon) does not reduce bowel movement and does not cause constipation. Sulfadiazine (Microsulfon) does not enhance the elimination of fluids and does not cause hypovolemia. Sulfadiazine (Microsulfon) does not increase the serum sodium levels and does not cause hypernatremia.
The nurse should question the prescription of tetracycline for which patient? 1 A 6-year-old patient with Haemophilus influenzae 2 A 45-year-old patient with a history of diabetes mellitus 3 A 60-year-old patient with a history of hypertension 4 A 40-year-old patient diagnosed with rickettsiae
A 6-year-old patient with Haemophilus influenzae Tetracycline is contraindicated in children younger than 8 years because it can cause permanent discoloration of the teeth. Tetracycline is not contraindicated for patients diagnosed with diabetes mellitus or hypertension. Tetracycline is used to treat rickettsiae.
What information will the nurse provide to a patient receiving rifampin? 1 A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears. 2 Oral contraception is the preferred method of birth control when using rifampin. 3 Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities. 4 The patient will only need to take this medication for the prescribed 14-day period.
A nonharmful side effect of the drug is red-orange discoloration of urine, sweat, and tears. Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful. Rifampin does not cause peripheral neuropathies (INH does), but it does interfere with the effectiveness of oral contraceptives. All antitubercular drugs need to be taken long-term in order to eradicate the slow-growing mycobacterium lying deep within the tissues.
A patient who is diagnosed with a Staphylococcus aureus infection is on penicillin treatment. On performing a culture test after 2 weeks, the report still shows the presence of the bacteria, S. aureus. What would be the reason for this condition?
Acquired resistance Presence of S. aureus in the culture even after treating with penicillin indicates that the bacteria have become resistant to penicillin or developed acquire resistance. If the patient develops a secondary infection due to the disturbance in normal flora of the body it is called superinfection. Cross-sensitivity occurs if the patient is prescribed with drugs that have similar actions such as penicillin and cephalosporin. Nosocomial infections are hospital-acquired infections.
The nurse is caring for a patient who is taking antibiotics. The patient reports flushing, itching, hives, anxiety, and throat and tongue swelling. The nurse finds that the patient has a rapid, irregular pulse. Which condition may the patient have as a result of taking the antibiotic? 1 Clostridium difficile bacterial infection 2 An allergic anaphylactic reaction 3 Tolerance to the antibiotic drugs 4 Glucose-6-phosphate dehydrogenase deficiency
An allergic anaphylactic reaction The patient has developed an allergic anaphylactic reaction to the penicillin antibiotics. Flushing, itching, hives, anxiety, and throat and tongue swelling are symptoms associated with an allergic anaphylactic reaction. In this condition, the patient's pulse rate may become rapid and irregular. Watery diarrhea, abdominal pain, and fever are the symptoms of a Clostridium difficile infection. The administration of antibiotics to patients with glucose-6-phosphate dehydrogenase deficiency leads to hemolysis. The patient has no symptoms associated with hemolysis and therefore does not have glucose-6-phosphate dehydrogenase deficiency.
The nurse is preparing to administer vaccines to a young child. What will the nurse do initially? 1 Rub the site of the vaccination with alcohol. 2 Explain active and passive immunity to the child and caregivers. 3 Ask the caregivers about food allergies and over-the-counter medications. 4 Tell the child to lie on the stomach to receive the vaccines.
Ask the caregivers about food allergies and over-the-counter medications. Before immunizations are administered, children and their caregivers should be questioned regarding their use of prescription and over-the-counter medications, including herbal preparations and any food or drug allergies. Depending on the patient's allergies, the other interventions may not occur if it is determined that it is too dangerous for the patient to receive the vaccine.
A 22-year-old female patient is put on amoxicillin. Which is the most important intervention for this patient? 1 Instruct the patient to not take the medication before meals. 2 Assess if the patient is on oral contraceptives. 3 Inform the patient about possible superinfections. 4 Assess the patient for cross sensitivity.
Assess if the patient is on oral contraceptives. This medication may decrease the effectiveness of oral contraceptives. The nurse needs to assess whether or not the patient is on oral contraceptives and whether or not the patient is sexually active. The other interventions are not as important a priority as the potential for pregnancy.
A patient has been on sulfonamides for urinary tract infections. The nurse assesses the patient and finds bruises on the legs and arms. What is the nurse's best action? 1 Ask the patient if someone is abusing her. 2 Assess the patient's platelet counts. 3 Tell the patient to be more careful. 4 Administer vitamin K to the patient.
Assess the patient's platelet counts. Blood disorders such as hemolytic anemia, aplastic anemia, and low white blood cell and platelet counts could result from prolonged use and high dosages. The nurse should assess the patient before assuming vitamin K deficiency, potential abuse, or frequent falls.
The primary health care provider instructs the nurse to administer intravenous penicillin. Which nursing action would be beneficial prior to administering the drug? 1 Locating the intravenous (IV) site 2 Recording the daily urine output 3 Obtaining serum creatinine levels 4 Assessing the client for any allergies
Assessing the client for any allergies The nurse should ask the patient about whether the patient is allergic to penicillin or not, before administering. This will prevent hypersensitivity reactions due to penicillin. Locating the intravenous site should be done if the patient has no known allergies to penicillin. The urine output should be recorded and serum creatinine levels should be obtained after injecting the penicillin for dosage adjustment.
The health care provider orders the nurse to vaccinate a patient who has a previous history of adverse reactions in response to a vaccine. Which precautions does the nurse take while administering the vaccine? Select all that apply. A Check the patient's food habits. B Ensure epinephrine is readily available. C Obtain the patient's complete drug history. D Administer saline before giving the vaccine. E Assess for signs such as fever after administering the vaccine.
B Ensure epinephrine is readily available. C Obtain the patient's complete drug history. Epinephrine helps reverse anaphylactic reaction. Thus, before administering the vaccine to the patient, the nurse ensures that epinephrine injections are ready to treat and prevent severe anaphylaxis. Prescription medications may react with the vaccine and cause harmful effects. Thus, the nurse obtains the patient's complete drug history prior to vaccination. Food interactions do not normally occur with vaccines; thus, the nurse need not obtain a history of the patient's food habits. Saline does not prevent anaphylactic reactions and need not be administered before giving the vaccine. Fever is a common reaction associated with almost all vaccines. It does not indicate severe anaphylactic reaction.
The nurse is preparing to administer a vaccine to a child. What information does the nurse gather from the parents before the vaccination? Select all that apply. A Body weight of the child B Prescription medication taken by the child C Over-the-counter drugs taken by the child D Complaints of diarrhea in the child E Presence of any food or drug allergy in the child
B Prescription medication taken by the child C Over-the-counter drugs taken by the child E Presence of any food or drug allergy in the child Prescription medications and over-the-counter drugs may interact with vaccines. Thus, the nurse should gather the child's history regarding the use of these drugs. A child who has a food or drug allergy may also develop adverse reactions to the vaccine. Thus, the nurse asks the parents about the presence of food or drug allergies in the child. The dose of the vaccine is not dependent on the child's body weight. Thus, the nurse need not assess the child's body weight prior to vaccination. Diarrhea is not a contraindication for receiving vaccines.
The nurse is caring for a patient taking foscarnet (Foscavir). What will the nurse monitor to identify potential side effects of this medication? 1 Hemoglobin and hematocrit 2 Blood urea nitrogen and creatinine 3 Platelets 4 Stool guaiac
Blood urea nitrogen and creatinine Foscarnet (Foscavir) can cause kidney damage. Blood urea nitrogen and creatinine should be closely monitored.
A patient is hospitalized for the treatment of tuberculosis. How can the development of multidrug-resistant tuberculosis be prevented in the patient? 1 By performing regular chest x-rays 2 By performing regular sputum cultures 3 By performing drug susceptibility tests 4 By performing regular blood tests
By performing drug susceptibility tests Preventing drug susceptibility tests will help prevent the development of multidrug-resistant tuberculosis in the patient. A drug susceptibility test is performed on the first Mycobacterium species that is isolated from a patient specimen. Chest x-rays, sputum culture, and blood tests are done for diagnosis and prognosis of tuberculosis and are not preventive.
The parent of a child who received a vaccination 2 hours ago informs the nurse that the child has developed fever and swelling at the site of injection. How does the nurse respond to the parent? Select all that apply. A "Your child requires administration of saline." B "Your child requires a chest X-ray." C "You should immediately admit the child to the hospital." D "You can apply cold compresses around the area of injection." E "You should give your child some acetaminophen."
D "You can apply cold compresses around the area of injection." E "You should give your child some acetaminophen." Fever and mild swelling at the site of vaccine injection are mild reactions following the administration of the vaccine. The onset of these symptoms occurs within hours. The nurse should inform the patient that the swelling can be reduced by applying cold compresses around the site of infection. Acetaminophen is an antipyretic drug that will help reduce the fever. Saline administration is not required, as dehydration is not a complication associated with vaccines. The signs exhibited by the child are not indicative of lung pathology, and thus a chest X-ray is not required. Fever and swelling are common mild reactions to vaccination and are often resolved in a day. They do not require hospitalization.
The nurse is caring for a patient who is taking rifampin (Rifadin). The patient has a heart rate of 90 beats/min, blood pressure of 100/89 mm Hg, and red-orange urine. What is the nurse's best action? 1 Document the findings and teach the patient. 2 Call the health care provider. 3 Collect a urine culture. 4 Discard the first void and start a 24-hour urine collection.
Document the findings and teach the patient. Red-orange discoloration of body fluids is a common side effect of rifampin (Rifadin), but it is not harmful and does not indicate infection. There is no need to call the health care provider, collect a urine culture, or start 24-hour urine collection.
A patient receiving metronidazole (Flagyl) treatment reports shortness of breath, facial flushing, severe headache, sweating, slurred speech, and abdominal cramps. Which of the patient's actions could have led to this condition? 1 Drinking alcohol 2 Taking vitamin B6 3 Taking echinacea 4 Swishing the medication
Drinking alcohol A patient receiving metronidazole (Flagyl) treatment should avoid drinking alcohol to prevent drug interaction that results in a disulfiram reaction. Disulfiram reactions are manifested by shortness of breath, facial flushing, severe headache, sweating, slurred speech, and abdominal cramps. Taking vitamin B6 helps prevent peripheral neuropathy in patients who are on antitubercular treatment. Taking echinacea along with ketoconazole (Nizoral) may lead to hepatotoxicity. Swishing the medication is advised for patients receiving any suspensions such as nystatin (Mycostatin); however, this would not be a possible reason for this patient's condition.
The nurse is caring for a patient who has been prescribed cefazolin sodium (Ancef). Which nursing assessment is the priority? 1 History, including allergies 2 Cardiac assessment 3 Neurological assessment 4 History of immunizations
History, including allergies Antibiotic allergy is one of the most common drug allergies. These allergies also have the potential to cause severe anaphylaxis and death and, therefore, have more importance than the other assessments listed.
The patient taking intravenous gentamicin (Garamycin) has elevated blood urea nitrogen (BUN). What is the nurse's best course of action? 1 Have the patient increase fluid intake. 2 Monitor peak and trough levels. 3 Hold the medication. 4 Insert a Foley catheter.
Hold the medication. Gentamicin (Garamycin) has a high potential for nephrotoxicity and is thus contraindicated in patients with elevated renal function tests such as BUN and creatinine. The nurse should hold the medication and call the health care provider. Increasing fluids will not decrease the patient's BUN.
A patient has been prescribed trimethoprim-sulfamethoxazole (Bactrim, Septra). Which intervention is appropriate? 1 Instruct the patient to take the medication for 14 days. 2 Ensure the patient eats something when taking the medication. 3 Assess the patient's urine before and after treatment. 4 Instruct the patient to increase fluids in the diet.
Instruct the patient to increase fluids in the diet. Increased fluid intake is highly recommended to avoid complications such as crystallization in the urine. The course of therapy is not always 14 days; the patient does not have to take the drug on a full stomach, and the drug is not prescribed only for urinary tract infections.
Which medication is used as perioperative prophylaxis in colorectal surgery? 1 Bacitracin (BaciiM) 2 Metronidazole (Flagyl) 3 Ketoconazole (Nizoral) 4 Colistimethate sodium (Coly-Mycin M)
Metronidazole (Flagyl) Metronidazole (Flagyl) is effective in treating gastrointestinal disorders by impairing deoxyribonucleic acid function of susceptible bacteria. Therefore, it is used as perioperative prophylaxis in colorectal surgery to prevent infections. Bacitracin (BaciiM) is a polypeptide and acts by inhibiting bacterial cell-wall synthesis and damaging the cell-wall membrane of the pathogen. Therefore, it is used to treat skin and ophthalmic infections. Ketoconazole (Nizoral) is an antifungal medication used to treat systemic fungal infection. Colistimethate sodium (Coly-Mycin M) is a peptide used in the treatment of Pseudomonas aeruginosa infections.
Once a child has received a vaccination, what action is the nurse's priority? 1 Monitor for possible anaphylaxis. 2 Assess for muscle pain. 3 Treat pain at the injection site. 4 Assess for infection
Monitor for possible anaphylaxis. Anaphylaxis is a potentially life-threatening adverse reaction to vaccines. Muscle pain and pain at the injection site can occur, but assessment and treatment of these is not the primary action. Infection is not likely from a vaccination.
A patient is prescribed penicillin G potassium (Pfizerpen) for treating a respiratory infection. What would be the appropriate nursing interventions for this patient? Select all that apply. 1 Monitoring for superinfection 2 Monitoring the patient for respiratory distress 3 Obtaining a culture and sensitivity test after starting the therapy 4 Having availability of epinephrine to treat severe allergic reaction 5 Advising the patient to take the medication with an empty stomach
Monitoring for superinfection Monitoring the patient for respiratory distress Having availability of epinephrine to treat severe allergic reaction When taking penicillin for a prolonged time, it may cause superinfections. Therefore, monitoring for stomatitis, which is a type of superinfection, is required. Respiratory distress is a severe allergic reaction after a first or second dose of penicillin. Epinephrine is used to treat a severe allergic reaction that may occur with the use of penicillin. A culture and sensitivity test should be obtained before starting the therapy for effective treatment. Penicillins should be taken with food to avoid gastric irritation.
Which type of immunity does the newborn obtain from the mother? 1 Herd immunity 2 Cell-mediated immunity 3 Naturally acquired passive immunity 4 Artificially acquired passive immunity
Naturally acquired passive immunity The newborn obtains naturally acquired passive immunity from the mother. The mother passes maternal antibodies directly, either through the placenta to the fetus or through breast milk to the nursing infant. Herd immunity is acquired through the administration of passive immunizing drugs such as antivenins, antitoxins, and immunoglobulin. Cell-mediated immunity is the immune response mediated by T cells. It helps to antagonize the allergic reactions caused by B cells. Artificially acquired passive immunity is developed only through administration of vaccines.
A patient with genital herpes is on acyclovir (Zovirax) therapy. Which complication in the patient would occur due to the administration of this drug in large doses? 1 Ototoxicity 2 Nephrotoxicity 3 Aplastic anemia 4 Cardiovascular collapse
Nephrotoxicity Acyclovir (Zovirax) is prescribed for the treatment of genital herpes. Large doses of acyclovir (Zovirax) may lead to nephrotoxicity. Conditions such as ototoxicity (toxicity of the ear), aplastic anemia (decrease of leukocytes, erythrocytes, and thrombocytes), and cardiovascular collapse are not associated with the administration of acyclovir (Zovirax). Ototoxicity, aplastic anemia, and cardiovascular collapse are associated with chloroquine HCl (Aralen HCl) administration, which is prescribed for the treatment of malaria.
Which action does the nurse take if a patient receiving intravenous vancomycin (Vancocin) complains of facial pruritis? 1 Gives diphenhydramine (Benadryl) with the infusion 2 Documents that the patient has a hypersensitivity reaction 3 Wraps the infusion in foil to protect from light 4 Programs the vancomycin to infuse at a slower rate
Programs the vancomycin to infuse at a slower rate The nurse infuses vancomycin over at least one hour, as rapid infusion can cause red man syndrome. It is indicated by flushing or itching of the face, neck, and trunk, as well as more serious problems like tachycardia and hypotension. Diphenhydramine (Benadryl) is a hypnotic drug used for treating histamine-mediated allergies, motion sickness and promotion of sleep. Pruritus in a patient taking vancomycin is more an indication of red man syndrome than hypersensitivity. Orally disintegrating medicines are wrapped in foils which, once administered, dissolve on the patient's tongue.
The nurse is caring for a patient with infection who is on sulfonamide therapy. The nurse finds that the patient developed skin rashes after taking the medication. Which intervention helps to ensure safety in the patient? A Administering another sulfonamide B Replacing sulfonamide with other antibiotics C Administering antiallergics along with sulfonamides D Applying topical sulfonamide preparations on the rashes
Replacing sulfonamide with other antibiotics When a patient is hypersensitive to one sulfonamide medication, the patient may develop allergic reactions to all other sulfonamide preparations due to cross-sensitivity. Therefore, the patient should completely avoid taking sulfonamides, topical or otherwise, and should substitute them with other antibiotics with the primary health care provider's approval. Prescribing antiallergics with sulfonamides may not help in reducing the patient's hypersensitivity to sulfonamides. This intervention can only alleviate the symptoms of hypersensitivity; it does not prevent cross-sensitivity.
A patient who is on nonsteroidal antiinflammatory drug therapy is diagnosed with a severe lower respiratory tract infection. The primary health care provider prescribed levofloxacin (Levaquin). Which complication will the patient most likely develop? 1 Seizures 2 Ototoxicity 3 Nephrotoxicity 4 Encephalopathy
Seizures Levofloxacin (Levaquin) is the drug of choice for severe lower respiratory tract infections. Levofloxacin (Levaquin) should not be administered with nonsteroidal antiinflammatory drugs (NSAIDs), because it may cause central nervous system reactions such as seizures. Ototoxicity is an adverse effect of vancomycin (Vancocin). Nephrotoxicity may be seen with high doses of amphotericin B (Fungizone). Encephalopathy is an adverse effect of streptomycin sulfate (Streptomycin) and may not be seen when levoflaxacin (Levaquin) is administered along with NSAIDs.
The nurse is caring for a patient who has been taking antibacterials for two weeks and reports symptoms consistent with oral candidiasis. What would be the cause of this condition? 1 Superinfection 2 Cross-resistance 3 Antibiotic resistance 4 Nosocomial infection
Superinfection Superinfection is a secondary infection that occurs when the normal flora of the gut are destroyed by the antibiotic use and lead to overgrowth of fungus. Cross-resistance occurs between the antibacterial drugs that have similar actions. Antibiotic resistance occurs when bacteria reduces or eliminates the effectiveness of the antibacterial drug. Nosocomial infection is an infection that has occurred in the hospital.
When instructing a patient about antibiotic therapy, the nurse explains that which condition occurs when the normal flora are disturbed during antibiotic therapy? 1 Hypersensitivity 2 Rebound toxicity 3 Organ toxicity 4 Superinfection
Superinfection Antibiotic therapy can destroy the normal flora of the body, which typically inhibit the overgrowth of fungi and yeast. When the normal flora are decreased, these organisms can overgrow and cause infections.
A patient is diagnosed with an oral candidal infection. Which intervention will the nurse expect to implement? 1 Start an IV so the patient does not have to eat by mouth. 2 Instruct the patient to brush her teeth and gargle hourly. 3 Teach the patient how to take nystatin (Mycostatin). 4 Administer valacyclovir hydrochloride (Valtrex) and monitor lips and gums.
Teach the patient how to take nystatin (Mycostatin). Nystatin (Mycostatin) is an antifungal ointment that is used for a variety of candidal infections. The patient needs to be taught how to "swish and swallow" to treat this infection. There is no need to brush the teeth hourly or administer Valtrex, and starting an IV is an extreme measure.
The nurse is caring for a patient who is being treated for acne. The nurse anticipates that the health care provider is most likely to treat the patient using which medication? 1 Polymyxin 2 Bacitracin 3 Tetracycline 4 Vancomycin
Tetracycline Tetracycline is considered to be a drug of choice for the treatment of acne rather than the other medications listed.
The nurse is caring for a patient who is on trimethoprim-sulfamethoxazole (Septra) treatment. The laboratory reports show decreased platelet and white blood cell counts. What should the nurse interpret from these findings? A The patient has hyperkalemia. B The patient has superinfection. C The patient has blood dyscrasias. D The patient has photosensitivity reaction.
The patient has blood dyscrasias. Trimethoprim-sulfamethoxazole (Septra) may cause a hematological reaction in the patient. It may result in blood dyscrasias and life-threatening anemia in the patient. Sore throat, purpura, and decreased platelet and white blood cell count are symptoms of a hematological reaction. Hematological reactions may lead to blood dyscrasias. Hyperkalemia does not refer to platelet and white blood cell count. Muscle weakness and tiredness are the manifestations of hyperkalemia. Anal or genital discharge, furry black tongue, and stomatitis are the manifestations of superinfection. Reddened and burning skin is a manifestation of photosensitivity reaction.
During a home visit, the nurse finds that a patient has not received the varicella vaccine in the past. On further assessment, the nurse concludes that the patient need not receive this vaccine. Which assessment finding led the nurse to this conclusion? 1 The patient is over 50 years of age. 2 The patient has had chickenpox in the past. 3 The patient is on antimicrobial therapy for ear infection. 4 The patient does not have a family history of chicken pox.
The patient has had chickenpox in the past. If a patient has had chicken pox in the past, the patient would have acquired natural immunity against varicella infection. Thus, the patient need not be given varicella vaccine. Aging may decrease immune function. Thus, if a patient is over 50 years of age and non-immune, varicella vaccine should be given. Antimicrobial therapy does not render a patient immune to viral infections. Thus, the nurse should give varicella vaccine to a patient who is on antimicrobial therapy for ear infection. Varicella infection does not run in families. Thus, a patient who does not have a family history of chicken pox still needs varicella vaccine.
The primary health care provider prescribes vitamin B6 to a patient on antitubercular therapy. What is the rationale behind the intervention? 1 To reduce meningitis 2 To reduce peptic ulcer 3 To reduce athlete's foot 4 To reduce peripheral neuropathy
To reduce peripheral neuropathy Antituberculars block absorption of pyridoxine (vitamin B6), which is used for intracellular enzyme production. Therefore, pyridoxine (vitamin B6) is prescribed to avoid deficiency and possible occurrence of peripheral neuropathy. Meningitis may be treated by antifungals and antiprotozoans. Peptic ulcer, caused by Helicobacter pylori, may be treated with metronidazole (Flagyl). Athlete's foot may be treated with antifungal medications.
The nurse is caring for a patient who is on antibiotic therapy for cardiac surgical prophylaxis. The nurse observes red blotching of the face, neck, and chest of the patient. Which medication is associated with this side effect of "red man" syndrome? 1 Lincomycin (Lincocin) 2 Clindamycin (Cleocin) 3 Telithromycin (Ketek) 4 Vancomycin (Vancocin)
Vancomycin (Vancocin) Vancomycin (Vancocin) is used in cardiac surgical prophylaxis when the patient is allergic to penicillin. Red blotching of the face, neck, and chest refers to "red man" syndrome or "red neck" syndrome. This condition occurs in the client due to rapid intravenous administration of vancomycin (Vancocin). Lincomycin (Lincocin) and clindamycin (Cleocin) may cause anaphylactic shock. Telithromycin (Ketek) may lead to an exacerbation of myasthenia gravis.
The primary health care provider prescribes vancomycin (Vancocin) to a patient who has a streptococcal infection. What will the nurse assess in the patient to ensure safe administration of the drug? 1 Skin integrity 2 Renal function 3 Blood glucose concentration
renal function Vancomycin (Vancocin) is a tricyclic glycopeptide, which causes nephrotoxicity. Therefore, the nurse should check the patient's renal function before administering vancomycin (Vancocin). Renal impairment may lead to severe toxicity. The dosing frequency of vancomycin (Vancocin) is dependent on renal function. Therefore, it is important to check the patient's renal function. Vancomycin (Vancocin) does not affect skin integrity, blood glucose concentration, or red blood cell counts; therefore, the nurse need not check these in the patient.
