Nokea
The nurse is completing an ongoing assessment of a client receiving erythromycin. The nurse would notify the primary health care provider immediately if assessment reveals which of the following? Select all that apply.
- A. Significant drop in blood pressure
- B. Increase in heart rate
- C. Decrease in temperature
- D. Increase in respiratory rate
Correct Answer: A, B, D, E
Rationale: During ongoing assessment of a client receiving erythromycin, the nurse should notify the primary health care provider immediately if the client has a significant drop in blood pressure, increase in heart rate, increase in respiratory rate, or sudden increase in temperature.
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A nurse suspects that a patient receiving an aminoglycoside is developing neurotoxicity based on assessment of which of the following? Select all that apply.
- A. Paresthesias
- B. Tingling around the mouth
- C. Ringing in the ears
- D. Vertigo
Correct Answer: A, B, E
Rationale: Signs and symptoms of neurotoxicity include numbness, skin tingling, circumoral (around the mouth) paresthesia, peripheral paresthesia, tremors, muscle twitching, convulsions, muscle weakness, and neuromuscular blockade (acute muscular paralysis and apnea). Ringing in the ears and vertigo would suggest ototoxicity.
A nurse is reading a journal article about spectinomycin. Which of the following would the nurse expect to find as being discussed about this drug? Select all that apply.
- A. Spectinomycin is used to treat chlamydia infections.
- B. Spectinomycin is used to treat gonorrhea infections.
- C. Spectinomycin is chemically unrelated to aminoglycosides.
- D. Spectinomycin can be used in clients with penicillin allergy.
Correct Answer: B, D, E
Rationale: Spectinomycin is used to treat gonorrhea infections in clients who are allergic to penicillins, cephalosporins, or probenecid (Benemid). Spectinomycin is chemically related to but different from aminoglycosides. No significant drug or food interactions for spectinomycin are known.
A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?
- A. Take the drug on an empty stomach.
- B. Take the drug along with a meal.
- C. Take the drug along with milk or fruit juice.
- D. Take the drug immediately after meals.
Correct Answer: A
Rationale: Oral preparations of tetracycline should be administered on an empty stomach with a full glass of water to maximize absorption. Tetracycline is not absorbed effectively if taken with food, with dairy products, or immediately after meals.
A group of nursing students are reviewing information about clindamycin (Cleocin). The students demonstrate understanding of this drug when they identify that it should be used with caution in clients with which of the following? Select all that apply.
- A. Seizure disorder
- B. GI disorders
- C. Myasthenia gravis
- D. Diabetes
Correct Answer: B, C, E
Rationale: Clindamycin, a lincosamide, should be used cautiously in clients with a history of GI disorders, renal disease, liver impairment, or myasthenia gravis.
A middle-aged patient has been prescribed tetracycline as part of his treatment of H. pylori. The patient has a history of heart disease for which he is receiving digoxin. Given his history and current medications, the patient is at risk for which of the following conditions?
- A. Respiratory depression
- B. Decreased effectiveness of tetracycline
- C. Prolonged clotting times
- D. Risk of digoxin toxicity
Correct Answer: D
Rationale: When digoxin interacts with tetracyclines, the patient is at risk for digoxin toxicity. Respiratory depression is an effect observed when neuromuscular blocking drugs interact with lincosamides. A decrease in the effectiveness of tetracycline is seen when the drug is taken with antacids, dairy products, or iron. An increased risk for bleeding with prolonged clotting times is noted when tetracycline is given with anticoagulants.