Nokea
A client is receiving iron therapy for anemia. The prescriber has ordered tetracycline as treatment for the client's infection. Which of the following would be most appropriate for the nurse to do?
- A. Give the drugs at the same time.
- B. Give the iron first, then follow with the tetracycline in 30 minutes.
- C. Separate administration times by 2 hours.
- D. Withhold the iron until the tetracycline therapy is completed.
Correct Answer: C
Rationale: Iron therapy can interfere with the absorption of tetracycline. Therefore, the nurse should give the iron 2 hours before or after administering tetracycline. The two drugs should not be given at the same time. Withholding the iron would be inappropriate.
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The nurse is teaching a client about possible adverse reactions that can occur with tetracyclines. The nurse determines that the teaching was successful when the client identifies which of the following? Select all that apply.
- A. Photosensitivity
- B. Hypoglycemia
- C. Diarrhea
- D. Stomatitis
Correct Answer: A, D, E
Rationale: The nurse should advise the client that nausea, vomiting, diarrhea, epigastric distress, stomatitis, sore throat, skin rashes, and photosensitivity are adverse reactions that may occur with the administration of tetracyclines.
The nurse is completing an ongoing assessment of a client receiving erythromycin. The nurse would notify the primary health care provider immediately if assessment reveals which of the following? Select all that apply.
- A. Significant drop in blood pressure
- B. Increase in heart rate
- C. Decrease in temperature
- D. Increase in respiratory rate
Correct Answer: A, B, D, E
Rationale: During ongoing assessment of a client receiving erythromycin, the nurse should notify the primary health care provider immediately if the client has a significant drop in blood pressure, increase in heart rate, increase in respiratory rate, or sudden increase in temperature.
A middle-aged patient has been prescribed tetracycline as part of his treatment of H. pylori. The patient has a history of heart disease for which he is receiving digoxin. Given his history and current medications, the patient is at risk for which of the following conditions?
- A. Respiratory depression
- B. Decreased effectiveness of tetracycline
- C. Prolonged clotting times
- D. Risk of digoxin toxicity
Correct Answer: D
Rationale: When digoxin interacts with tetracyclines, the patient is at risk for digoxin toxicity. Respiratory depression is an effect observed when neuromuscular blocking drugs interact with lincosamides. A decrease in the effectiveness of tetracycline is seen when the drug is taken with antacids, dairy products, or iron. An increased risk for bleeding with prolonged clotting times is noted when tetracycline is given with anticoagulants.
After teaching a group of nursing students about indications for linezolid (Zyvox), the instructor determines a need for additional teaching when the students identify which of the following as an indication?
- A. Community-acquired pneumonia (CAP)
- B. Vancomycin-resistant Enterococcus faecium (VREF)
- C. Methicillin-resistant Staphylococcus aureus (MRSA)
- D. Acute otitis media
Correct Answer: D
Rationale: Linezolid is used in the treatment of vancomycin-resistant Enterococcus faecium (VREF), health care? and community-acquired pneumonias, and skin and skin structure infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). It is not used to treat otitis media.
A group of nursing students are reviewing information about aminoglycosides. The students demonstrate understanding when they identify which of the following as an example? Select all that apply.
- A. Amikacin (Amikin)
- B. Amoxicillin (Amoxil)
- C. Kanamycin (Kantrex)
- D. None of the above
Correct Answer: A
Rationale: The aminoglycosides include amikacin, gentamicin, kanamycin, neomycin, streptomycin, and tobramycin. Amoxicillin is an aminopenicillin. Vancomycin is a miscellaneous agent that disrupts the bacterial cell wall. Azithromycin is classified as a macrolide.