Nokea
A nurse is monitoring a client who is receiving penicillin. The nurse would assess the client for which of the following common GI tract adverse reactions? Select all that apply.
- A. Glossitis
- B. Stomatitis
- C. Esopliagitis
- D. Diarrhea
- E. Gastritis
Correct Answer: A,B,D,E
Rationale: A nurse monitoring a client taking penicillin should be aware of the common GI tract adverse reactions, including glossitis, stomatitis, gastritis, nausea, vomiting, diarrhea, and abdominal pain.
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After teaching a group of nursing students about the different generations of cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a first-generation cephalosporin? Select all that apply.
- A. Cefepime (Maxipime)
- B. Cefazolin (Ancef)
- C. Cefoxitin (Mefoxin)
- D. Cephalexin (Keflex)
- E. Cefaclor (Raniclor)
Correct Answer: B,D
Rationale: Cefazolin and cephalexin are examples of first-generation cephalosporins. Cefoxitin and cefaclor are examples of second-generation cephalosporins. Cefepime is an example of a fourth-generation cephalosporin.
A client develops a mild skin irritation while receiving penicillin therapy. Which of the following would the nurse advise the client to avoid? Select all that apply.
- A. Harsh soaps
- B. Perfumed lotions
- C. Antipyretic creams
- D. Rubbing the irritating area
- E. Wearing rough or irritating clothing
Correct Answer: A,B,D,E
Rationale: When skin irritation is present during the administration of penicillin, the nurse should advise the client to avoid harsh soaps, perfumed lotions, rubbing the irritated area, or wearing rough or irritating clothing.
A nurse is reviewing the laboratory test results of a client receiving penicillin therapy. Which of the following would the nurse identify as indicating an adverse hematologic reaction? Select all that apply.
- A. Pancytopenia
- B. Anemia
- C. Thrombocytopenia
- D. Leukopenia
- E. Hemoglobulinemia
Correct Answer: B,C,D
Rationale: Nurses should monitor blood counts of clients taking penicillins for the following hematopoietic changes: anemia, thrombocytopenia, leucopenia, and bone marrow suppression.
After taking penicillin as prescribed, a patient shows signs of diarrhea and informs the nurse that there is blood in his stools. Which of the following interventions should the nurse do next?
- A. Contact primary health provider immediately.
- B. Have the patient consume yogurt with his next meal.
- C. Decrease fiber content in diet.
- D. Continue with prescribed regimen.
Correct Answer: A
Rationale: If diarrhea is suspected, the nurse should notify the primary health care provider immediately. The nurse should wait for the primary health care provider's instructions before continuing with the prescribed regimen. Yogurt or buttermilk may help prevent fungal superinfections, but they will not help alleviate the patient's condition at this stage. Changes in the diet are not recommended unless instructed by the primary health care provider.
Before administering the first dose to the client, which assessment should the nurse perform as part of the preadministration assessment?
- A. Review of renal and hepatic function tests
- B. Inspection of patient's stools
- C. Evaluation of patient's lifestyle and diet
- D. General history of patient's health
Correct Answer: D
Rationale: Before administering the first dose of penicillin, the nurse should obtain and review the patient's general health history, including any allergy history, a history of all medical and surgical treatments, a drug history, and the current symptoms of the infection. The patient's stool is examined only after penicillin has been administered if the patient has diarrhea. It is not required to evaluate the patient's lifestyle and diet as part of the preadministration assessment for the first dose. Renal and hepatic function tests may be performed at intervals during penicillin therapy, usually not before it.