Nokea
A nurse suspects that a patient receiving an aminoglycoside is developing neurotoxicity based on assessment of which of the following? Select all that apply.
- A. Paresthesias
- B. Tingling around the mouth
- C. Ringing in the ears
- D. Vertigo
Correct Answer: A, B, E
Rationale: Signs and symptoms of neurotoxicity include numbness, skin tingling, circumoral (around the mouth) paresthesia, peripheral paresthesia, tremors, muscle twitching, convulsions, muscle weakness, and neuromuscular blockade (acute muscular paralysis and apnea). Ringing in the ears and vertigo would suggest ototoxicity.
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A patient is prescribed demeclocycline. The nurse would teach the patient to be alert for signs of which of the following?
- A. Photosensitivity
- B. Abdominal pain
- C. Cramping
- D. Blood dyscrasias
Correct Answer: A
Rationale: Demeclocycline causes photosensitivity reactions. Abdominal pain and cramping are adverse reactions of macrolides. Blood dyscrasias are an adverse reaction of lincosamides.
After teaching a group of nursing students about indications for linezolid (Zyvox), the instructor determines a need for additional teaching when the students identify which of the following as an indication?
- A. Community-acquired pneumonia (CAP)
- B. Vancomycin-resistant Enterococcus faecium (VREF)
- C. Methicillin-resistant Staphylococcus aureus (MRSA)
- D. Acute otitis media
Correct Answer: D
Rationale: Linezolid is used in the treatment of vancomycin-resistant Enterococcus faecium (VREF), health care? and community-acquired pneumonias, and skin and skin structure infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). It is not used to treat otitis media.
A group of nursing students are reviewing information about clindamycin (Cleocin). The students demonstrate understanding of this drug when they identify that it should be used with caution in clients with which of the following? Select all that apply.
- A. Seizure disorder
- B. GI disorders
- C. Myasthenia gravis
- D. Diabetes
Correct Answer: B, C, E
Rationale: Clindamycin, a lincosamide, should be used cautiously in clients with a history of GI disorders, renal disease, liver impairment, or myasthenia gravis.
A client has been receiving an aminoglycoside for several weeks and comes to the clinic complaining of ringing in his ears and some dizziness. The nurse suspects ototoxicity. When developing this client's plan of care, which nursing diagnosis would be the priority?
- A. Impaired Comfort
- B. Altered Thought Process
- C. Diarrhea
- D. Risk for Injury
Correct Answer: D
Rationale: The development of ototoxicity would lead the nurse to identify a nursing diagnosis of Risk for Injury related to the effects of ototoxicity. Although the client's ringing in the ears could cause discomfort, the priority nursing diagnosis would be Risk for Injury. There is no evidence of impaired comfort, altered thought process or diarrhea.
A patient is prescribed demeclocycline. The nurse would teach the patient to be alert for signs of which of the following?
- A. Photosensitivity
- B. Abdominal pain
- C. Cramping
- D. Blood dyscrasias
Correct Answer: A
Rationale: Demeclocycline causes photosensitivity reactions. Abdominal pain and cramping are adverse reactions of macrolides. Blood dyscrasias are an adverse reaction of lincosamides.