Nokea
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.
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The nurse is reviewing the medical records of several patients who are receiving fluoroquinolone therapy. Each of the patients is also receiving corticosteroid therapy. Which patient would the nurse identify as being at greatest risk for tendonitis?
- A. 34-year-old female
- B. 22-year-old male
- C. 45-year-old female
- D. 72-year-old male
Correct Answer: D
Rationale: Tendonitis and tendon rupture risk increase when taking a fluoroquinolone. Although this can happen at any age, those older than 60 years who also take corticosteroids are at greater risk.
After teaching a group of nursing students about fluoroquinolones, the instructor determines that the teaching was successful when they identify which of the following as an example? Select all that apply.
- A. Levofloxacin (Levaquin)
- B. Amoxicillin (Amoxil)
- C. Cephalexin (Keflex)
- D. Spectinomycin (Trobicin)
- E. Ciprofloxacin (Cipro)
Correct Answer: A,E
Rationale: The fluoroquinolone drugs include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). Amoxicillin is an aminopenicillin. Spectinomycin is chemically related to but different from aminoglycosides.
The nurse is reviewing the medical records of several clients with infection. The nurse would anticipate the prescriber ordering a fluoroquinolone for a client with which of the following? Select all that apply.
- A. Unitary tract infections
- B. Sexually transmitted infections
- C. Upper respiratory tract infections
- D. Bone and joint infections
- E. Skin infections
Correct Answer: A,B,D,E
Rationale: Fluoroquinolones are primarily used to treat lower respiratory tract infections, bone and joint infections, urinary tract infections, skin infections, sexually transmitted infections, and some infections of the eye and ear.
A client is receiving a fluoroquinolone as an extended-release formulation. Which of the following would be most important to include in the client's teaching plan?
- A. To chew, crush, or break the medication
- B. To swallow the medication whole
- C. To limit the daily fluid intake
- D. To take the drug with an antacid
Correct Answer: B
Rationale: When an extended-release formulation is prescribed, the client needs instructions to swallow the medication whole and not to chew, crush, or break the medication. Otherwise, the amount of drug released would be too great for the body all at once Clients should be encouraged to increase their fluid intake and to separate administration by 1 to 2 hours.
A patient develops a superinfection due to fluoroquinolone therapy. The patient asks the nurse why this happened. Which response by the nurse would be most appropriate?
- A. Your infection was really severe, so the drug wasn't as effective as it could have been.
- B. This happens when your original infection begins to clear.
- C. The drug disrupts your normal bacteria so it allows other organisms to grow.
- D. We really don't know why this happens; it just does sometimes.
Correct Answer: C
Rationale: Antibiotics can disrupt the normal flora (nonpathogenic bacteria in the bowel), causing a secondary infection or superinfection. This new infection is 'superimposed' on the original infection. The destruction of large numbers of nonpathogenic bacteria (normal flora) by the antibiotic alters the chemical environment. This allows uncontrolled growth of bacteria or fungal microorganisms that are not affected by the antibiotic being administered. It has nothing to do with the drug's effectiveness or the original infection being cleared.