Nokea
A nursing student is engaged in researching information about fluoroquinolones. When reviewing the information, the student would most likely find that this class of drugs is effective in treating which type of infection? Select all that apply.
- A. Viral infections
- B. Gram-positive infections
- C. Fungal infections
- D. Gram-negative infections
- E. Parasitic infections
Correct Answer: B,D
Rationale: Fluoroquinolones are effective in treating infections caused by gram-positive and gram-negative microorganisms.
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A patient develops a superinfection due to fluoroquinolone therapy. The patient asks the nurse why this happened. Which response by the nurse would be most appropriate?
- A. Your infection was really severe, so the drug wasn't as effective as it could have been.
- B. This happens when your original infection begins to clear.
- C. The drug disrupts your normal bacteria so it allows other organisms to grow.
- D. We really don't know why this happens; it just does sometimes.
Correct Answer: C
Rationale: Antibiotics can disrupt the normal flora (nonpathogenic bacteria in the bowel), causing a secondary infection or superinfection. This new infection is 'superimposed' on the original infection. The destruction of large numbers of nonpathogenic bacteria (normal flora) by the antibiotic alters the chemical environment. This allows uncontrolled growth of bacteria or fungal microorganisms that are not affected by the antibiotic being administered. It has nothing to do with the drug's effectiveness or the original infection being cleared.
A client receiving levofloxacin comes to the clinic for a follow-up visit. The client tells the nurse, 'I used sunscreen but it didn't help.' Which response by the nurse would be most helpful?
- A. Be sure to wear long sleeves and a wide-brimmed hat in addition to using sunscreen.
- B. I guess you didn't apply enough sunscreen to be effective.
- C. Maybe we need to change your medication because this is unusual.
- D. The sunscreen should have worked. Are you sure you actually did use it?
Correct Answer: A
Rationale: The fluoroquinolone drugs cause severe photosensitivity reactions. Clients may experience 'sunburn' reactions even when they use sunscreen or sunblock products. Caution clients to wear cover-up clothing with long sleeves and wide-brimmed hats when outside in addition to sunblock preparations. Remind them that sunscreen needs to be applied repeatedly throughout the day or when going into water. Clients should be aware that glare during hazy or cloudy days can cause skin reactions as readily as direct sunlight on a clear day. Telling the client that he didn't apply enough or questioning the client's actual use of sunscreen is inappropriate. There is no need to change the medication because the client's report is not unusual.
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 receiving levofloxacin comes to the clinic for a follow-up visit. The client tells the nurse, 'I used sunscreen but it didn't help.' Which response by the nurse would be most helpful?
- A. Be sure to wear long sleeves and a wide-brimmed hat in addition to using sunscreen.
- B. I guess you didn't apply enough sunscreen to be effective.
- C. Maybe we need to change your medication because this is unusual.
- D. The sunscreen should have worked. Are you sure you actually did use it?
Correct Answer: A
Rationale: The fluoroquinolone drugs cause severe photosensitivity reactions. Clients may experience 'sunburn' reactions even when they use sunscreen or sunblock products. Caution clients to wear cover-up clothing with long sleeves and wide-brimmed hats when outside in addition to sunblock preparations. Remind them that sunscreen needs to be applied repeatedly throughout the day or when going into water. Clients should be aware that glare during hazy or cloudy days can cause skin reactions as readily as direct sunlight on a clear day. Telling the client that he didn't apply enough or questioning the client's actual use of sunscreen is inappropriate. There is no need to change the medication because the client's report is not unusual.
During ongoing assessment of clients taking fluoroquinolone, which of the following adverse reactions should be reported to the physician immediately? Select all that apply.
- A. Respiratory difficulty
- B. Drowsiness
- C. Severe diarrhea
- D. Hypersensitivity reaction
- E. A significant drop in blood pressure
Correct Answer: A,C,D,E
Rationale: It is important for the nurse to report any adverse reaction to the physician prior to administering the next dose but the nurse should notify the physician immediately if respiratory difficulty, hypersensitivity reaction, severe diarrhea, or a decided drop in blood pressure occurs.