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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After teaching a group of students about tetracyclines, the instructor determines that the teaching was successful when the students identify which of the following as a true statement? Select all that apply.
- A. Tetracyclines are broad-spectrum antibiotics.
- B. Tetracyclines may cause permanent discoloration of the teeth in children.
- C. Tetracyclines can be used when penicillins are contraindicated.
- D. Tetracyclines are contraindicated in children younger than 6 years.
- E. Tetracyclines are used to treat Rocky Mountain spotted fever.
Correct Answer: A, B, C, E
Rationale: Tetracyclines are broad-spectrum antibiotics used to treat rickettsial disease, such as Rocky Mountain spotted fever, and when the use of penicillins is contraindicated. Tetracyclines are not given to children younger than 9 years of age unless absolutely necessary because these drugs may cause permanent yellow-gray-brown discoloration of the teeth.
A client is receiving iron therapy for anemia. The prescriber has ordered tetracycline as treatment for the client's infection. Which of the following would be most appropriate for the nurse to do?
- A. Give the drugs at the same time.
- B. Give the iron first, then follow with the tetracycline in 30 minutes.
- C. Separate administration times by 2 hours.
- D. Withhold the iron until the tetracycline therapy is completed.
Correct Answer: C
Rationale: Iron therapy can interfere with the absorption of tetracycline. Therefore, the nurse should give the iron 2 hours before or after administering tetracycline. The two drugs should not be given at the same time. Withholding the iron would be inappropriate.
A patient is ordered to receive neomycin as part of the treatment plan for hepatic coma. Which of the following would be most important for the nurse to assess before administering this drug? Select all that apply.
- A. Ability to swallow
- B. Level of consciousness
- C. Baseline vital signs
- D. Pulmonary function
Correct Answer: A, B
Rationale: During the early stages of hepatic coma, various changes in the level of consciousness may be seen. At times, the patient may appear lethargic and respond poorly to commands. Because of these changes in the level of consciousness, the patient may have difficulty swallowing, and a danger of aspiration is present. If the patient appears to have difficulty taking an oral drug, the nurse should withhold the drug and contact the primary health care provider. Baseline vital signs are important but are not the priority when the patient has hepatic coma. The drug does not affect the patient's respiratory function. There is no infection; therefore, there is no need for culture and sensitivity testing.
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 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.