Nokea
A woman is traveling to a country where she will be at high risk for malarial infection. What will the nurse teach her regarding prophylactic therapy with hydroxychloroquine?
- A. Hydroxychloroquine is better absorbed and has fewer adverse effects if taken on an empty stomach.
- B. The drug is started 3 weeks before exposure but can be discontinued once she leaves the area.
- C. The medication is taken only when she observes mosquito bites because it can have toxic effects if taken unnecessarily.
- D. The drug is usually started 1 to 2 weeks before traveling to endemic areas and is continued for 4 weeks after leaving the area.
Correct Answer: D
Rationale: Prophylaxis of malaria with hydroxychloroquine is usually started 1 to 2 weeks before exposure and continued for 4 weeks after the person has left the area. The medication should be taken with food to decrease gastrointestinal upset.
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A patient with an intestinal infection that is positive for the Giardia lamblia organism will be taking an antiprotozoal drug. The nurse will include which information in the teaching plan for this patient?
- A. The urine may become dilute and pale during therapy.
- B. Taking the medications with food reduces gastrointestinal upset.
- C. The medications should be taken on an empty stomach.
- D. The drugs may be discontinued once the diarrhea subsides.
Correct Answer: B
Rationale: Taking these drugs with food reduces gastrointestinal upset. Antiprotozoal drugs may cause the urine to turn dark. These drugs should be administered for the prescribed length of time to ensure complete eradication of the infection.
Hydroxychloroquine is prescribed as part of malaria prophylaxis for a patient who will be traveling. The nurse will discuss which potential adverse effects with the patient? (Select all that apply.)
- A. Diarrhea
- B. Myalgia
- C. Insomnia
- D. Dizziness
- E. Vomiting
- F. Headache
Correct Answer: A,D,E,F
Rationale: Diarrhea, anorexia, nausea, vomiting, dizziness, rash, and headache are potential adverse effects of hydroxychloroquine. Myalgia and insomnia are not adverse effects of this drug.
A patient is receiving hydroxychloroquine therapy but tells the nurse that she has never traveled out of her city. The nurse knows that a possible reason for this drug therapy is which of these conditions?
- A. Lyme disease
- B. Toxoplasmosis
- C. Systemic lupus erythematosus
- D. Intestinal tapeworms
Correct Answer: C
Rationale: Hydroxychloroquine, which is used for malaria, also possesses anti-inflammatory actions and has been used to treat rheumatoid arthritis and systemic lupus erythematosus. The other options are incorrect.
A patient who is being treated for malaria has started therapy with quinine and tetracycline. He asks the nurse why he is on an antibiotic when malaria is caused by a parasite. Which response by the nurse is correct?
- A. The tetracycline prevents reinfection by the malarial parasite.
- B. The antibiotic is combined with quinine to reduce the side effects of the quinine.
- C. An antibacterial drug prevents the occurrence of superinfection during antimalarial therapy.
- D. The two drugs are more effective against malaria when given together.
Correct Answer: D
Rationale: The combination of quinine and tetracycline takes advantage of their synergistic protozoacidal effects. The other responses are incorrect.
A patient with Pneumocystis jirovecii pneumonia will be receiving pentamidine as an intravenous piggyback (IVPB) dose. The medication has been added to a 100-mL bag of D5W for the infusion, and it needs to infuse over 120 minutes. The nurse will set the infusion pump to infuse at what rate for this IVPB medication?
Correct Answer: 50 mL/hr
Rationale: First, convert 120 minutes to hours because the infusion pump will infuse at a milliliter per hour rate. 120 minutes ?? (1 hour / 60 minutes) = 2 hours. 100 mL ?· 2 hours = 50 mL/hr.