Nokea
If a patient is taking fluconazole with an oral anticoagulant, the nurse will monitor for which possible interaction?
- A. Reduced action of oral anticoagulants
- B. Increased effects of oral anticoagulants
- C. Hypokalemia
- D. Decreased effectiveness of the antifungal drug
Correct Answer: B
Rationale: Azole antifungal drugs increase the effects of oral anticoagulants. As a result, increased bleeding may occur.
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A patient is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?
- A. Chew the lozenges until they are completely dissolved
- B. Let the lozenges dissolve slowly and completely in your mouth without chewing it
- C. Rinse your mouth with water before taking the inhaler
- D. Rinse your mouth with mouthwash after taking the inhaler
Correct Answer: B
Rationale: Nystatin may be given orally in the form of lozenges, or troches, which need to be slowly and completely dissolved in the mouth for optimal effects; tablets are not to be chewed or swallowed whole. Patients taking an inhaled corticosteroid must rinse their mouths with water thoroughly after taking the inhaler.
The nurse is administering one of the lipid formulations of amphotericin B. When giving this drug, which concept is important to remember?
- A. The lipid formulations may be given in oral form.
- B. The doses are much lower than the doses of the older drugs.
- C. The lipid formulations are associated with fewer adverse effects than the older drugs.
- D. There is no difference in cost between the newer and older forms.
Correct Answer: C
Rationale: Newer lipid formulations of amphotericin B have been developed in an attempt to decrease the incidence of its adverse effects and increase its efficacy. However, the lipid formulations are more costly.
A patient is infected by invasive aspergillosis, and the medical history reveals that the patient has not been able to tolerate several antifungal drugs. The nurse anticipates an order for which medication to treat this infection?
- A. Fluconazole
- B. Micafungin
- C. Caspofungin
- D. Nystatin
Correct Answer: C
Rationale: Caspofungin is used for treating severe infection by Aspergillus species (invasive aspergillosis) in patients who are intolerant of or refractory to other drugs.
The nurse is preparing an infusion of amphotericin B for a patient who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B?
- A. Discontinuing the infusion immediately if fever, chills, or nausea occur
- B. Gradually increasing the infusion rate until the expected adverse effects occur
- C. If fever, chills, or nausea occur during the infusion, administering medications to treat the symptoms
- D. Before beginning the infusion, administering an antipyretic and an antiemetic drug
Correct Answer: D
Rationale: Almost all patients given the drug intravenously experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. For this reason, pretreatment with an antipyretic (acetaminophen), antihistamines, and antiemetics may be conducted to decrease the severity of the infusion-related reaction.
The nurse is reviewing instructions for vaginal antifungal drugs with a patient. Which statement by the nurse is an appropriate instruction regarding these drugs?
- A. The medication can be stopped when your symptoms are relieved.
- B. Discontinue this medication if menstruation begins.
- C. Daily douching is part of the treatment for vaginal fungal infections.
- D. Abstain from sexual intercourse until the treatment has been completed and the infection has resolved.
Correct Answer: D
Rationale: Female patients taking antifungal medications for the treatment of vaginal infections need to abstain from sexual intercourse until the treatment has been completed and the infection has resolved. The medication needs to be taken for as long as prescribed. Instruct patients to continue to take the medication even if they are actively menstruating. Douching is not an appropriate intervention.