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A nurse is reviewing the signs and symptoms of a fungal superinfection with a client. The client demonstrates understanding of the information when he identifies which of the following as suggesting a fungal superinfection? Select all that apply.
- A. Bloody diarrhea
- B. Abdominal cramping
- C. Creamy white patches on the throat
- D. Intense vaginal itching
- E. Excoriation of the anogenital skin folds
Correct Answer: C,D,E
Rationale: A fungal superinfection commonly occurs in the mouth, vagina, and anogenital areas, commonly manifested by creamy, white, lace-like patches on the tongue, mouth, or throat; white or yellow vaginal discharge; anal or vaginal itching or redness; and inflammation or excoriation of the mouth or the skin folds of the anogenital area. Bacterial superinfections commonly occur in the bowel, manifested by fever, diarrhea with visible blood or mucus, and abdominal cramping.
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A client is receiving a fluoroquinolone and is also taking ibuprofen for pain relief. The nurse would be alert for which of the following?
- A. Increased risk for bleeding
- B. Decreased effectiveness of the fluoroquinolone
- C. Increased risk for seizures
- D. Delayed elimination of the fluoroquinolone
Correct Answer: C
Rationale: When a nonsteroidal anti-inflammatory drug such as ibuprofen is used in conjunction with a fluoroquinolone, the patient has an increased risk for seizures. An increased risk of bleeding would occur with oral anticoagulants in conjunction with fluoroquinolone therapy. Decreased effectiveness of the fluoroquinolone would occur if it was given with antacids, iron salts, or zinc because of decreased absorption of the antibiotic. Cimetidine interferes with the elimination of the fluoroquinolone, leading to prolonged presence of the drug in the bloodstream.
A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and the client receives intravenous fluids and protein supplementation. The physician prescribes medication as part of the treatment plan. The nurse would expect to administer which of the following?
- A. Fidaxomicin
- B. Metronidazole
- C. Norfloxacin
- D. Moxifloxacin
Correct Answer: A
Rationale: Moderate to severe cases of pseudomembranous colitis may require treatment with intravenous (IV) fluids and electrolytes, protein supplementation, and treatment with drugs such as fidaxomicin (Dificid) to eliminate the microorganism. Metronidazole is used to treat infections involving anaerobic organisms. Norfloxacin and moxifloxacin are fluoroquinolones and would not be used.
A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should teach the client about which of the following common adverse reactions? Select all that apply.
- A. Constipation
- B. Nausea
- C. Headache
- D. Dizziness
- E. Dry mouth
Correct Answer: B,C,D
Rationale: Common adverse reactions to fluoroquinolones include nausea, vomiting, diarrhea, headache, abdominal pain or discomfort, dizziness, and photosensitivity. Constipation and dry mouth are not associated with fluoroquinolone therapy.
A nurse is reviewing the signs and symptoms of a fungal superinfection with a client. The client demonstrates understanding of the information when he identifies which of the following as suggesting a fungal superinfection? Select all that apply.
- A. Bloody diarrhea
- B. Abdominal cramping
- C. Creamy white patches on the throat
- D. Intense vaginal itching
- E. Excoriation of the anogenital skin folds
Correct Answer: C,D,E
Rationale: A fungal superinfection commonly occurs in the mouth, vagina, and anogenital areas, commonly manifested by creamy, white, lace-like patches on the tongue, mouth, or throat; white or yellow vaginal discharge; anal or vaginal itching or redness; and inflammation or excoriation of the mouth or the skin folds of the anogenital area. Bacterial superinfections commonly occur in the bowel, manifested by fever, diarrhea with visible blood or mucus, and abdominal cramping.
Fluoroquinolones should be used with caution in which of the following clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hypertension
- C. Clients receiving dialysis
- D. Clients with chronic obstructive pulmonary disorder (COPD)
- E. Clients with epilepsy
Correct Answer: A,C,E
Rationale: Fluoroquinolones should be used with caution in clients with diabetes, renal impairment, or history of seizures, older clients, and clients on dialysis.