Nokea
Fluoroquinolones should be used with caution in which of the following clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hypertension
- C. Clients receiving dialysis
- D. Clients with chronic obstructive pulmonary disorder (COPD)
- E. Clients with epilepsy
Correct Answer: A,C,E
Rationale: Fluoroquinolones should be used with caution in clients with diabetes, renal impairment, or history of seizures, older clients, and clients on dialysis.
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A client is receiving a fluoroquinolone and is also taking ibuprofen for pain relief. The nurse would be alert for which of the following?
- A. Increased risk for bleeding
- B. Decreased effectiveness of the fluoroquinolone
- C. Increased risk for seizures
- D. Delayed elimination of the fluoroquinolone
Correct Answer: C
Rationale: When a nonsteroidal anti-inflammatory drug such as ibuprofen is used in conjunction with a fluoroquinolone, the patient has an increased risk for seizures. An increased risk of bleeding would occur with oral anticoagulants in conjunction with fluoroquinolone therapy. Decreased effectiveness of the fluoroquinolone would occur if it was given with antacids, iron salts, or zinc because of decreased absorption of the antibiotic. Cimetidine interferes with the elimination of the fluoroquinolone, leading to prolonged presence of the drug in the bloodstream.
After teaching a group of nursing students about fluoroquinolones, the instructor determines that the teaching was successful when they identify which of the following as an example? Select all that apply.
- A. Levofloxacin (Levaquin)
- B. Amoxicillin (Amoxil)
- C. Cephalexin (Keflex)
- D. Spectinomycin (Trobicin)
- E. Ciprofloxacin (Cipro)
Correct Answer: A,E
Rationale: The fluoroquinolone drugs include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). Amoxicillin is an aminopenicillin. Spectinomycin is chemically related to but different from aminoglycosides.
A nurse is preparing to administer ciprofloxacin as ordered. Which test would the nurse ensure is completed before administering the first dose to the patient?
- A. Urinalysis
- B. Culture tests
- C. Ulcer tests
- D. Stool tests
Correct Answer: B
Rationale: The nurse should check whether culture tests are conducted before the first dose of drug, is administered to the client. Ulcer tests and stool tests are not required to be conducted before administering the first dose of an anti-infective drug to the client. The nurse has to ensure that urinalysis is conducted before the administration of the drug but not specifically before the first dose of the anti-infective drug.
A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and the client receives intravenous fluids and protein supplementation. The physician prescribes medication as part of the treatment plan. The nurse would expect to administer which of the following?
- A. Fidaxomicin
- B. Metronidazole
- C. Norfloxacin
- D. Moxifloxacin
Correct Answer: A
Rationale: Moderate to severe cases of pseudomembranous colitis may require treatment with intravenous (IV) fluids and electrolytes, protein supplementation, and treatment with drugs such as fidaxomicin (Dificid) to eliminate the microorganism. Metronidazole is used to treat infections involving anaerobic organisms. Norfloxacin and moxifloxacin are fluoroquinolones and would not be used.
A nursing student is engaged in researching information about fluoroquinolones. When reviewing the information, the student would most likely find that this class of drugs is effective in treating which type of infection? Select all that apply.
- A. Viral infections
- B. Gram-positive infections
- C. Fungal infections
- D. Gram-negative infections
- E. Parasitic infections
Correct Answer: B,D
Rationale: Fluoroquinolones are effective in treating infections caused by gram-positive and gram-negative microorganisms.