Nokea
A nurse is reading a journal article about spectinomycin. Which of the following would the nurse expect to find as being discussed about this drug? Select all that apply.
- A. Spectinomycin is used to treat chlamydia infections.
- B. Spectinomycin is used to treat gonorrhea infections.
- C. Spectinomycin is chemically unrelated to aminoglycosides.
- D. Spectinomycin can be used in clients with penicillin allergy.
Correct Answer: B, D, E
Rationale: Spectinomycin is used to treat gonorrhea infections in clients who are allergic to penicillins, cephalosporins, or probenecid (Benemid). Spectinomycin is chemically related to but different from aminoglycosides. No significant drug or food interactions for spectinomycin are known.
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A patient is receiving telithromycin. Based on the nurse's understanding of potential adverse reactions, the nurse would identify which nursing diagnosis as a priority?
- A. Ineffective Renal Tissue Perfusion
- B. Risk for Injury
- C. Diarrhea
- D. Risk for Impaired Skin Integrity
Correct Answer: B
Rationale: Telithromycin can cause visual disturbances such as difficulty focusing and accommodating to light. Therefore, the priority nursing diagnosis would be Risk for Injury related to these visual disturbances. Aminoglycosides can cause nephrotoxicity, leading to a nursing diagnosis of Ineffective Renal Perfusion. Although diarrhea and skin rashes can occur, these would not be a priority at this time.
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 is reviewing the medical records of several patients who are to receive antibacterial drug therapy. The nurse understands that aminoglycosides would be contraindicated in clients with which of the following conditions? Select all that apply.
- A. Pre-existing hearing loss
- B. Pregnancy
- C. Parkinsonism
- D. None of the above
Correct Answer: A, B, C
Rationale: The aminoglycosides are contraindicated in clients with pre-existing hearing loss, myasthenia gravis, and parkinsonism and during lactation and pregnancy.
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.
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.