Nokea
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.
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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 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.
A patient has received a prescription for a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, saying, 'I don't want to do this for 2 weeks!' Which is a possibility in this situation?
- A. A single dose of a vaginal antifungal cream
- B. A one-time infusion of amphotericin B
- C. A single dose of a fluconazole (Diflucan) oral tablet
- D. There is no better alternative to the suppositories
Correct Answer: C
Rationale: A single oral dose of fluconazole may be used to treat vaginal candidiasis.
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.