Nokea
A patient with a Pseudomonas species urinary infection will be receiving amikacin 5 mg/kg once daily via intravenous infusion. The patient weighs 143 pounds, and the medication is available in an injection solution strength of 250 mg/mL. Identify how many milliliters of medication will be drawn up for this injection. (record answer using one decimal place)
Correct Answer: 1.3 Ml
Rationale: Calculate the patient's weight in kilograms: 143 pounds ?· 2.2 = 65 kg. Calculate mg/kg/dose: 5 mg/kg ?? 65 kg = 325 mg. Calculate volume: 325 mg ?· 250 mg/mL = 1.3 mL.
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A patient will be receiving nitrofurantoin treatment for a urinary tract infection. The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.)
- A. Liver disease
- B. Coronary artery disease
- C. Hyperthyroidism
- D. Type 1 diabetes mellitus
- E. Chronic renal disease
Correct Answer: A,E
Rationale: Nitrofurantoin is contraindicated in cases of known drug allergy and also in cases of significant renal function impairment, because the drug concentrates in the urine. Because adverse effects include hepatotoxicity, which is rare but often fatal, the nurse should also question the order if liver disease is present. The other options are not contraindications.
The nurse is administering a vancomycin infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration?
- A. Monitoring blood pressure for hypertension during the infusion
- B. Discontinuing the drug immediately if red man syndrome occurs
- C. Restricting fluids during vancomycin therapy
- D. Infusing the drug over at least 1 hour
Correct Answer: D
Rationale: Infuse the medication over at least 1 hour to reduce the occurrence of red man syndrome. Adequate hydration (at least 2 L of fluid in 24 hours) during vancomycin therapy is important for the prevention of nephrotoxicity. Hypotension may occur during the infusion, especially if it is given too rapidly.
Which problem may occur in a patient who has started aminoglycoside therapy?
- A. Constipation
- B. Renal damage
- C. Gynecomastia
- D. Leukocytosis
Correct Answer: B
Rationale: Patients on aminoglycoside therapy have an increased risk for nephrotoxicity. The other options are incorrect.
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy?
- A. Metronidazole
- B. Ciprofloxacin
- C. Vancomycin
- D. Tobramycin
Correct Answer: C
Rationale: Vancomycin is the antibiotic of choice for the treatment of MRSA. The other drugs are not used for MRSA.
A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs?
- A. Neuralgia
- B. Double vision
- C. Hypotension
- D. Tendonitis and tendon rupture
Correct Answer: D
Rationale: A black box warning is required by the U.S. Food and Drug Administration for all quinolones because of the increased risk for tendonitis and tendon rupture with use of the drugs. This effect is more common in elderly patients, patients with renal failure, and those receiving concurrent glucocorticoid therapy (e.g., prednisone). The other options are not common adverse effects.