Nokea
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.
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A nurse is reading a journal article about spectinomycin. Which of the following would the nurse expect to find as being discussed about this drug? Select all that apply.
- A. Spectinomycin is used to treat chlamydia infections.
- B. Spectinomycin is used to treat gonorrhea infections.
- C. Spectinomycin is chemically unrelated to aminoglycosides.
- D. Spectinomycin can be used in clients with penicillin allergy.
Correct Answer: B, D, E
Rationale: Spectinomycin is used to treat gonorrhea infections in clients who are allergic to penicillins, cephalosporins, or probenecid (Benemid). Spectinomycin is chemically related to but different from aminoglycosides. No significant drug or food interactions for spectinomycin are known.
A nurse is preparing to administer lincomycin via IM injection. Which of the following would be most appropriate for the nurse to do? Select all that apply.
- A. Inspect previous injection sites.
- B. Rotate the injection site.
- C. Use the abdomen for intramuscular injections.
- D. Note the site used for injection in the client's chart.
Correct Answer: A, B, D, E
Rationale: When giving lincomycin intramuscularly, the nurse inspects previous injection sites for signs of pain or tenderness, redness, and swelling; reports the persistence of a localized reaction to the physician; rotates the injection sites; and records the site used for injection in the client's chart.
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.
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 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.