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A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and the client receives intravenous fluids and protein supplementation. The physician prescribes medication as part of the treatment plan. The nurse would expect to administer which of the following?
- A. Fidaxomicin
- B. Metronidazole
- C. Norfloxacin
- D. Moxifloxacin
Correct Answer: A
Rationale: Moderate to severe cases of pseudomembranous colitis may require treatment with intravenous (IV) fluids and electrolytes, protein supplementation, and treatment with drugs such as fidaxomicin (Dificid) to eliminate the microorganism. Metronidazole is used to treat infections involving anaerobic organisms. Norfloxacin and moxifloxacin are fluoroquinolones and would not be used.
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A client develops pseudomembranous colitis secondary to fluoroquinolone therapy. The nurse understands that this is the result of which organism?
- A. E. coli
- B. C. difficile
- C. Staphylococcus
- D. Group B hemolytic Streptococcus
Correct Answer: B
Rationale: Pseudomembranous colitis is one type of a bacterial superinfection. This potentially life-threatening problem develops because of an overgrowth of the microorganism Clostridium difficile (C. diff) in the bowel.
A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and the client receives intravenous fluids and protein supplementation. The physician prescribes medication as part of the treatment plan. The nurse would expect to administer which of the following?
- A. Fidaxomicin
- B. Metronidazole
- C. Norfloxacin
- D. Moxifloxacin
Correct Answer: A
Rationale: Moderate to severe cases of pseudomembranous colitis may require treatment with intravenous (IV) fluids and electrolytes, protein supplementation, and treatment with drugs such as fidaxomicin (Dificid) to eliminate the microorganism. Metronidazole is used to treat infections involving anaerobic organisms. Norfloxacin and moxifloxacin are fluoroquinolones and would not be used.
A client receiving levofloxacin comes to the clinic for a follow-up visit. The client tells the nurse, 'I used sunscreen but it didn't help.' Which response by the nurse would be most helpful?
- A. Be sure to wear long sleeves and a wide-brimmed hat in addition to using sunscreen.
- B. I guess you didn't apply enough sunscreen to be effective.
- C. Maybe we need to change your medication because this is unusual.
- D. The sunscreen should have worked. Are you sure you actually did use it?
Correct Answer: A
Rationale: The fluoroquinolone drugs cause severe photosensitivity reactions. Clients may experience 'sunburn' reactions even when they use sunscreen or sunblock products. Caution clients to wear cover-up clothing with long sleeves and wide-brimmed hats when outside in addition to sunblock preparations. Remind them that sunscreen needs to be applied repeatedly throughout the day or when going into water. Clients should be aware that glare during hazy or cloudy days can cause skin reactions as readily as direct sunlight on a clear day. Telling the client that he didn't apply enough or questioning the client's actual use of sunscreen is inappropriate. There is no need to change the medication because the client's report is not unusual.
Which of the following represent nursing diagnoses that may be made during administration of a fluoroquinolone? Select all that apply.
- A. Acute Pain
- B. Diarrhea
- C. Imbalanced Nutrition
- D. Anxiety
- E. Risk for Impaired Skin Integrity
Correct Answer: A,B,D,E
Rationale: Drug administration-specific nursing diagnoses that may be made during treatment with fluoroquinolones and miscellaneous anti-infective drugs include Acute Pain, Anxiety, Risk for Impaired Comfort, Risk for Impaired Skin Integrity, Diarrhea, Risk for Impaired Urinary Elimination, and Risk for Disturbed Sensory Perception.
Fluoroquinolones should be used with caution in which of the following clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hypertension
- C. Clients receiving dialysis
- D. Clients with chronic obstructive pulmonary disorder (COPD)
- E. Clients with epilepsy
Correct Answer: A,C,E
Rationale: Fluoroquinolones should be used with caution in clients with diabetes, renal impairment, or history of seizures, older clients, and clients on dialysis.