Nokea
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.
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After reviewing information about lincosamide therapy, a group of nursing students demonstrate understanding of the information when they identify which of the following as a contraindication?
- A. Children younger than 9 years
- B. Patients with pre-existing liver disease
- C. Patients taking cisapride
- D. Patients with myasthenia gravis
Correct Answer: C
Rationale: Lincosamide is contraindicated in patients taking cisapride. Tetracyclines are contraindicated in children younger than 9 years of age and pregnant women. Macrolides are contraindicated in patients with pre-existing liver disease and patients with myasthenia gravis.
A patient is being discharged with a prescription for linezolid. After teaching the patient about this drug, the nurse determines that additional teaching is needed when the patient identifies that he can consume which of the following without any risks? Select all that apply.
- A. Alcohol
- B. Prunes
- C. Aged cheese
- D. Pepperoni
Correct Answer: A, C, D
Rationale: When linezolid is taken with foods containing tyramine, such as aged cheese and meats, yogurt, chocolate, caffeinated beverages, and alcohol, the risk for severe hypertension increases. Prunes and broccoli pose no risk to the patient.
A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?
- A. Take the drug on an empty stomach.
- B. Take the drug along with a meal.
- C. Take the drug along with milk or fruit juice.
- D. Take the drug immediately after meals.
Correct Answer: A
Rationale: Oral preparations of tetracycline should be administered on an empty stomach with a full glass of water to maximize absorption. Tetracycline is not absorbed effectively if taken with food, with dairy products, or immediately after meals.
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.
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.