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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.
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Which of the following information should the nurse obtain during the preadministration assessment of a client prescribed a fluoroquinolone? Select all that apply.
- A. Blood glucose levels
- B. Allergy history
- C. Signs and symptoms of infection
- D. Blood pressure
- E. Temperature
Correct Answer: B,C,D,E
Rationale: Before administering a fluoroquinolone, the nurse identifies and records the signs and symptoms of the infections, takes a thorough allergy history, takes and records vital signs, and, if ordered, obtains cultures.
A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate understanding of the information when they identify that an empty stomach is essential for the administration of which drug?
- A. Ciprofloxacin
- B. Moxifloxacin
- C. Levofloxacin
- D. Norfloxacin
Correct Answer: D
Rationale: Although any of the fluoroquinolones can be given on an empty stomach, it is essential that norfloxacin is given in such a manner.
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.
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.
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.