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A nurse suspects that a client who is receiving a cephalosporin and has ingested alcohol may be experiencing a disulfiram-like reaction based on assessment of which of the following? Select all that apply.
- A. Flushing
- B. Respiratory difficulty
- C. Hypertension
- D. Vomiting
- E. Sweating
Correct Answer: A,B,D,E
Rationale: Flushing, throbbing in the head and neck, respiratory difficulty, vomiting, sweating, chest pain, and hypotension are symptoms a nurse might observe in a client having a disulfiram-like reaction with administration of a cephalosporin and alcohol.
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A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins. The nurse determines that the teaching was successful when the patient identifies which of the following? Select all that apply.
- A. Drowsiness
- B. Headache
- C. Constipation
- D. Heartburn
- E. Vomiting
Correct Answer: B,D,E
Rationale: Common adverse reactions to cephalosporins include nausea, vomiting, diarrhea, headache, dizziness, malaise, heartburn, and fever.
A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions would be most appropriate for the nurse to do when preparing penicillin in parenteral form?
- A. Extract penicillin from vial and then reconstitute.
- B. Save excess antibiotic after reconstitution for later use.
- C. Use any available diluent for reconstitution.
- D. Shake the vial well to distribute the drug evenly.
Correct Answer: D
Rationale: When preparing a parenteral form of penicillin, the nurse should shake the vial thoroughly before withdrawing the drug to ensure its even distribution in the solution. Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial. Excess antibiotic after reconstitution should never be saved, as the drug loses its potency when stored. Reconstitution should be done only with the diluent prescribed on the manufacturer's label.
A patient receiving penicillin therapy tells the nurse that she feels like her mouth is irritated and that she has a sore throat. Inspection reveals a red, swollen tongue with ulcerations. The nurse suspects a fungal superinfection and identifies which nursing diagnosis as most appropriate for this patient?
- A. Impaired Comfort
- B. Impaired Oral Mucous Membranes
- C. Deficient Knowledge
- D. Inadequate Nutrition: Less Than Body Requirements
Correct Answer: B
Rationale: The assessment suggests a fungal superinfection, which would lead to the nursing diagnosis of Impaired Oral Mucous Membranes. Although Impaired Comfort may be appropriate, Impaired Oral Mucous Membranes is more specific. There is no evidence of lack of knowledge or problems with nutrition. However, if the superinfection is not addressed, the patient may experience difficulty eating due to the irritation and discomfort.
A patient is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: D
Rationale: Each IV dose of vancomycin is infused over 60 minutes. Too rapid an infusion may result in a sudden and profound fall in blood pressure and shock.
A group of nursing students are reviewing information about administering penicillins. The students demonstrate an understanding of the information when they identify which drugs as being given without regard to meals? Select all that apply.
- A. Amoxicillin (Amoxil)
- B. Ampicillin (Principen)
- C. Penicillin V (Veetids)
- D. Amoxicillin/clavulanate (Augmentin)
- E. Carbenicillin indanyl (Geocillin)
Correct Answer: A,C
Rationale: Amoxicillin and penicillin V can be administered without regard to meals, unlike the rest of the penicillins, such as ampicillin, amoxicillin/clavulanate, or carbenicillin indanyl, which should be given on an empty stomach.