Nokea
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.
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A patient is scheduled for abdominal surgery and is ordered to receive kanamycin as part of the bowel preparation. The patient asks the nurse why he is getting this drug. Which response by the nurse would be most appropriate?
- A. You have an infection now and will probably have one after surgery, so this will help control it.
- B. We need to lower the levels of ammonia in your bloodstream to prevent problems.
- C. The drug helps eliminate bacteria so that your GI tract is as clean as possible for surgery.
- D. This is to help prevent you from developing any blood clots during and after the surgery.
Correct Answer: C
Rationale: Kanamycin and neomycin are used before surgery to reduce intestinal bacteria. It is thought that this reduces the possibility of abdominal infection that may occur after surgery on the bowel. By destroying bacteria in the gut and washing it out with laxatives or enemas, the surgical area becomes as clean as possible before the operation. The drug is not used to control an infection preoperatively. It does help to reduce blood ammonia levels with hepatic coma, but this is not the reason for its use with this patient. The drug has no effect on preventing blood clots postoperatively.
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 preparing to administer an aminoglycoside to a client. The nurse would be alert for the development of which of the following toxicities? Select all that apply.
- A. Nephrotoxicity
- B. Cardiotoxicity
- C. Ototoxicity
- D. Hepatotoxicity
Correct Answer: A, C, E
Rationale: More serious adverse reactions of aminoglycosides include nephrotoxicity, ototoxicity, and neurotoxicity. A nurse recognizing these can greatly reduce permanent damage to the client's hearing, kidneys, and nerves. Aminoglycosides are not associated with cardiotoxicity or hepatotoxicity.
A patient is receiving linezolid. The patient is fond of eating chocolates and coffee, both of which contain tyramine. The nurse would instruct the patient that he is at risk for which of the following should he consume foods containing tyramine while taking linezolid?
- A. Severe hypertension
- B. Drowsiness
- C. Nervousness
- D. Nausea
Correct Answer: A
Rationale: The nurse should inform the patient that if tyramine found in chocolates and coffee interacts with linezolid, the patient will develop an increased risk for severe hypertension. Tyramine-containing foods interacting with linezolid do not cause drowsiness, nervousness, or nausea.
A nurse is preparing to administer lincomycin via IM injection. Which of the following would be most appropriate for the nurse to do? Select all that apply.
- A. Inspect previous injection sites.
- B. Rotate the injection site.
- C. Use the abdomen for intramuscular injections.
- D. Note the site used for injection in the client's chart.
Correct Answer: A, B, D, E
Rationale: When giving lincomycin intramuscularly, the nurse inspects previous injection sites for signs of pain or tenderness, redness, and swelling; reports the persistence of a localized reaction to the physician; rotates the injection sites; and records the site used for injection in the client's chart.