A nurse is preparing a plan of care for a client who is prescribed an antiparasitic agent. Which nursing diagnosis would the nurse most likely identify related to the client's drug therapy?
- A. Impaired Comfort
- B. Diarrhea
- C. Risk for Ineffective Tissue Perfusion
- D. Risk for Deficient Fluid Volume
- E. Risk for Impaired Respiratory Function
Correct Answer: B,D,E
Rationale: Drug-specific nursing diagnoses when discussing the treatment of parasitic infection include Diarrhea, Risk for Deficient Fluid Volume, Imbalanced Nutrition, and Risk for Impaired Respiratory Function.
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A client is receiving amphotericin B IV. The nurse identifies a nursing diagnosis of Impaired Comfort related to medication administration. The nurse determines that the plan of care was effective when which outcome is achieved?
- A. Client remains free from rigors.
- B. Client exhibits a blood pressure within acceptable parameters.
- C. Client maintains a patent IV infusion site.
- D. Client maintains a urine output of at least 30 mL/hour.
- E. Client demonstrates procedure for cleaning involved area.
Correct Answer: A,B,C
Rationale: The patient receiving amphotericin B IV can experience rigors, hypotension, and problems with the IV infusion site. Therefore, remaining free from rigors and maintaining a stable blood pressure and a patent IV infusion site would indicate that the plan of care for impaired comfort is successful. A urine output of 30 mL/hour would be an indicator of adequate renal tissue perfusion. Cleaning the involved area would not be appropriate because the client has a systemic fungal infection.
A client who is receiving oral systemic antifungal therapy has a nursing diagnosis of Risk for Ineffective Renal Tissue Perfusion. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Monitoring urine output hourly
- B. Monitoring serum creatinine levels
- C. Evaluating blood urea nitrogen levels
- D. Premedicating the client with an antihistamine
Correct Answer: D
Rationale: For the nursing diagnosis of ineffective renal tissue perfusion, the nurse would monitor the client's urine output hourly and evaluate serum creatinine and BUN levels frequently. Premedicating the client with an antihistamine would only be appropriate if the client was receiving amphotericin B via IV infusion.
Foods that acidify the urine may interact with chloroquine and increase the drug's excretion, thereby decreasing its effectiveness in the treatment of malaria. The nurse should counsel the client to avoid which of the following foods during treatment with chloroquine?
- A. Plums
- B. Oranges
- C. Fish
- D. Eggs
- E. Cranberries
Correct Answer: A,C,D,E
Rationale: The nurse should counsel the client to avoid cranberries, plums, prunes, meats, cheeses, eggs, fish, and grains.
After teaching a group of nursing students about the actions of the various antifungal drugs, the instructor determines that the teaching was successful when the students identify which drug as having only fungistatic activity?
- A. Fluconazole
- B. Amphotericin B
- C. Miconazole
- D. Nystatin
Correct Answer: A
Rationale: Fluconazole has fungistatic activity, whereas amphotericin B, miconazole, and nystatin exert both fungicidal and fungistatic activity.
The nurse is teaching a client and his family about administering pentamidine at home. Which statement by the client indicates a need for additional teaching?
- A. I should protect the solution from direct light.
- B. The entire treatment should take no more than 15 minutes.
- C. I need to dissolve the drug in the correct amount of sterile water.
- D. Only the pentamidine solution should go into the nebulizer's reservoir.
Correct Answer: B
Rationale: The pentamidine treatment typically lasts about 30 to 45 minutes. The solution should be protected from light after the drug is dissolved with the proper amount of sterile water. No other drugs should be added to the reservoir.
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