Nokea
A patient is receiving linezolid. The patient is fond of eating chocolates and coffee, both of which contain tyramine. The nurse would instruct the patient that he is at risk for which of the following should he consume foods containing tyramine while taking linezolid?
- A. Severe hypertension
- B. Drowsiness
- C. Nervousness
- D. Nausea
Correct Answer: A
Rationale: The nurse should inform the patient that if tyramine found in chocolates and coffee interacts with linezolid, the patient will develop an increased risk for severe hypertension. Tyramine-containing foods interacting with linezolid do not cause drowsiness, nervousness, or nausea.
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A patient is receiving telithromycin. Based on the nurse's understanding of potential adverse reactions, the nurse would identify which nursing diagnosis as a priority?
- A. Ineffective Renal Tissue Perfusion
- B. Risk for Injury
- C. Diarrhea
- D. Risk for Impaired Skin Integrity
Correct Answer: B
Rationale: Telithromycin can cause visual disturbances such as difficulty focusing and accommodating to light. Therefore, the priority nursing diagnosis would be Risk for Injury related to these visual disturbances. Aminoglycosides can cause nephrotoxicity, leading to a nursing diagnosis of Ineffective Renal Perfusion. Although diarrhea and skin rashes can occur, these would not be a priority at this time.
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 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.
A nurse is reviewing the medical records of several patients who are to receive antibacterial drug therapy. The nurse understands that aminoglycosides would be contraindicated in clients with which of the following conditions? Select all that apply.
- A. Pre-existing hearing loss
- B. Pregnancy
- C. Parkinsonism
- D. None of the above
Correct Answer: A, B, C
Rationale: The aminoglycosides are contraindicated in clients with pre-existing hearing loss, myasthenia gravis, and parkinsonism and during lactation and pregnancy.
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.