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 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.
Prior to administration of moxifloxacin (Avelox), a nurse obtains a medication history. Use of which drug would alert the nurse to contact the prescriber because concomitant use would lead to an increased risk for a severe cardiac arrhythmia? Select all that apply.
- A. Amiodarone (Pacerone)
- B. Glyburide (DiaBeta)
- C. Solaid (Betapace)
- D. Procainamide (Procanbid)
- E. Ibuprofen (Motrin)
Correct Answer: A,C,D
Rationale: There is a risk of severe cardiac arrhythmias when moxifloxacin (Avelox) is administered with drugs that increase the QT interval, such as quinidine, procainamide, amiodarone, or sotalol.
A client is receiving a fluoroquinolone and is also taking ibuprofen for pain relief. The nurse would be alert for which of the following?
- A. Increased risk for bleeding
- B. Decreased effectiveness of the fluoroquinolone
- C. Increased risk for seizures
- D. Delayed elimination of the fluoroquinolone
Correct Answer: C
Rationale: When a nonsteroidal anti-inflammatory drug such as ibuprofen is used in conjunction with a fluoroquinolone, the patient has an increased risk for seizures. An increased risk of bleeding would occur with oral anticoagulants in conjunction with fluoroquinolone therapy. Decreased effectiveness of the fluoroquinolone would occur if it was given with antacids, iron salts, or zinc because of decreased absorption of the antibiotic. Cimetidine interferes with the elimination of the fluoroquinolone, leading to prolonged presence of the drug in the bloodstream.
A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate understanding of the information when they identify that an empty stomach is essential for the administration of which drug?
- A. Ciprofloxacin
- B. Moxifloxacin
- C. Levofloxacin
- D. Norfloxacin
Correct Answer: D
Rationale: Although any of the fluoroquinolones can be given on an empty stomach, it is essential that norfloxacin is given in such a manner.
A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should teach the client about which of the following common adverse reactions? Select all that apply.
- A. Constipation
- B. Nausea
- C. Headache
- D. Dizziness
- E. Dry mouth
Correct Answer: B,C,D
Rationale: Common adverse reactions to fluoroquinolones include nausea, vomiting, diarrhea, headache, abdominal pain or discomfort, dizziness, and photosensitivity. Constipation and dry mouth are not associated with fluoroquinolone therapy.