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A client is receiving quinupristin/dalfopristin via a peripheral intravenous infusion. After the drug is administered, the nurse would flush the intravenous line with which of the following?
- A. Normal saline
- B. 0.45% sodium chloride
- C. Dextrose 5% and water
- D. Heparin
Correct Answer: C
Rationale: Quinupristin/dalfopristin is irritating to the vein. After peripheral infusion, the vein should be flushed with 5% dextrose in water (D5W), because the drug is incompatible with saline or heparin flush solutions.
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A client is receiving quinupristin/dalfopristin via a peripheral intravenous infusion. After the drug is administered, the nurse would flush the intravenous line with which of the following?
- A. Normal saline
- B. 0.45% sodium chloride
- C. Dextrose 5% and water
- D. Heparin
Correct Answer: C
Rationale: Quinupristin/dalfopristin is irritating to the vein. After peripheral infusion, the vein should be flushed with 5% dextrose in water (D5W), because the drug is incompatible with saline or heparin flush solutions.
A nurse is reviewing the medical record of a client who is prescribed tetracycline. The nurse would be alert for an increased risk of toxicity if the client is taking which of the following? Select all that apply.
- A. Digoxin (Lanoxin)
- B. Phenytoin (Dilantin)
- C. Warfarin (Coumadin)
- D. None of the above
Correct Answer: A
Rationale: Tetracyclines may increase the risk of toxicity in clients who take digoxin for heart disease and increase the risk of bleeding in clients who take warfarin.
A nurse suspects that a patient receiving an aminoglycoside is developing neurotoxicity based on assessment of which of the following? Select all that apply.
- A. Paresthesias
- B. Tingling around the mouth
- C. Ringing in the ears
- D. Vertigo
Correct Answer: A, B, E
Rationale: Signs and symptoms of neurotoxicity include numbness, skin tingling, circumoral (around the mouth) paresthesia, peripheral paresthesia, tremors, muscle twitching, convulsions, muscle weakness, and neuromuscular blockade (acute muscular paralysis and apnea). Ringing in the ears and vertigo would suggest ototoxicity.
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.
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.