Nokea
A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?
- A. Increased risk of bleeding
- B. Increased action of neuromuscular blocking drugs
- C. Increased profound respiratory depression
- D. Decreased absorption of tetracycline
Correct Answer: D
Rationale: Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular blocking drugs and increased profound respiratory depression are the result of interaction between neuromuscular blocking drugs and tetracyclines. Increased risk of bleeding is a result of interaction between anticoagulants and tetracyclines.
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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 scheduled for abdominal surgery and is ordered to receive kanamycin as part of the bowel preparation. The patient asks the nurse why he is getting this drug. Which response by the nurse would be most appropriate?
- A. You have an infection now and will probably have one after surgery, so this will help control it.
- B. We need to lower the levels of ammonia in your bloodstream to prevent problems.
- C. The drug helps eliminate bacteria so that your GI tract is as clean as possible for surgery.
- D. This is to help prevent you from developing any blood clots during and after the surgery.
Correct Answer: C
Rationale: Kanamycin and neomycin are used before surgery to reduce intestinal bacteria. It is thought that this reduces the possibility of abdominal infection that may occur after surgery on the bowel. By destroying bacteria in the gut and washing it out with laxatives or enemas, the surgical area becomes as clean as possible before the operation. The drug is not used to control an infection preoperatively. It does help to reduce blood ammonia levels with hepatic coma, but this is not the reason for its use with this patient. The drug has no effect on preventing blood clots postoperatively.
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 gentamicin. Assessment of which of the following would lead the nurse to suspect that the client is developing nephrotoxicity? Select all that apply.
- A. Proteinuria
- B. Hematuria
- C. Decreased urine output
- D. Increased serum creatinine
Correct Answer: A, B, C, D
Rationale: Proteinuria, hematuria, decreased urine output, increased serum creatinine, and increased blood nitrogen urea (BUN) are suggestive of nephrotoxicity. Decreased fluid intake would support dehydration.
A patient is being discharged with a prescription for linezolid. After teaching the patient about this drug, the nurse determines that additional teaching is needed when the patient identifies that he can consume which of the following without any risks? Select all that apply.
- A. Alcohol
- B. Prunes
- C. Aged cheese
- D. Pepperoni
Correct Answer: A, C, D
Rationale: When linezolid is taken with foods containing tyramine, such as aged cheese and meats, yogurt, chocolate, caffeinated beverages, and alcohol, the risk for severe hypertension increases. Prunes and broccoli pose no risk to the patient.