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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.
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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.
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.
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.
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.
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.