Nokea
The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply.)
- A. Administering the medication by rapid IV infusion
- B. Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities
- C. If adverse effects occur, reducing the IV rate gradually until they subside
- D. Using an infusion pump for IV therapy
- E. Monitoring the IV site for signs of phlebitis and infiltration
- F. Administering premedication for fever and nausea
- G. Knowing that the intravenous solution for amphotericin B will be cloudy
Correct Answer: B,D,E,F
Rationale: If the patient develops tingling and numbness in the extremities (paresthesias), discontinue the drug immediately. An infusion pump is necessary for the infusion, and the nurse will monitor the IV site for signs of phlebitis and infiltration. Premedication to reduce the adverse effects of fever, malaise, and nausea may be ordered. The IV solution must be clear and without precipitates; and muscle weakness, not twitching, may indicate hypokalemia. The medication must be administered at the rate recommended and stopped, not slowed, if adverse reactions occur.
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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.
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.
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.
A patient with a severe fungal infection has orders for voriconazole. The nurse is reviewing the patient's medical record and would be concerned if which assessment finding is noted?
- A. Decreased breath sounds in the lower lobes
- B. Patient is also taking quinidine
- C. History of type 2 diabetes
- D. Potassium level of 4.0 mEq/L
Correct Answer: B
Rationale: Voriconazole is contraindicated when co-administered with certain other drugs metabolized by the cytochrome P-450 enzyme 3A4 (e.g., quinidine) because of the risk for inducing serious cardiac dysrhythmias.
A patient will be taking fluconazole 100 mg/day PO for 2 weeks. The patient is unable to swallow tablets, so an oral suspension that contains 10 mg/mL is available. Identify how many milliliters will the nurse administer with each dose.
Correct Answer: 10 mL
Rationale: Calculate dose: 100 mg/day ?· 10 mg/mL = 10 mL/day. The nurse will administer 10 mL of the oral suspension per dose.