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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.
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During ongoing assessment of clients taking fluoroquinolone, which of the following adverse reactions should be reported to the physician immediately? Select all that apply.
- A. Respiratory difficulty
- B. Drowsiness
- C. Severe diarrhea
- D. Hypersensitivity reaction
- E. A significant drop in blood pressure
Correct Answer: A,C,D,E
Rationale: It is important for the nurse to report any adverse reaction to the physician prior to administering the next dose but the nurse should notify the physician immediately if respiratory difficulty, hypersensitivity reaction, severe diarrhea, or a decided drop in blood pressure occurs.
A nursing student is engaged in researching information about fluoroquinolones. When reviewing the information, the student would most likely find that this class of drugs is effective in treating which type of infection? Select all that apply.
- A. Viral infections
- B. Gram-positive infections
- C. Fungal infections
- D. Gram-negative infections
- E. Parasitic infections
Correct Answer: B,D
Rationale: Fluoroquinolones are effective in treating infections caused by gram-positive and gram-negative microorganisms.
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.
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.
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.