Nokea
The nurse is reviewing the medical records of several clients with infection. The nurse would anticipate the prescriber ordering a fluoroquinolone for a client with which of the following? Select all that apply.
- A. Unitary tract infections
- B. Sexually transmitted infections
- C. Upper respiratory tract infections
- D. Bone and joint infections
- E. Skin infections
Correct Answer: A,B,D,E
Rationale: Fluoroquinolones are primarily used to treat lower respiratory tract infections, bone and joint infections, urinary tract infections, skin infections, sexually transmitted infections, and some infections of the eye and ear.
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Which of the following represent nursing diagnoses that may be made during administration of a fluoroquinolone? Select all that apply.
- A. Acute Pain
- B. Diarrhea
- C. Imbalanced Nutrition
- D. Anxiety
- E. Risk for Impaired Skin Integrity
Correct Answer: A,B,D,E
Rationale: Drug administration-specific nursing diagnoses that may be made during treatment with fluoroquinolones and miscellaneous anti-infective drugs include Acute Pain, Anxiety, Risk for Impaired Comfort, Risk for Impaired Skin Integrity, Diarrhea, Risk for Impaired Urinary Elimination, and Risk for Disturbed Sensory Perception.
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 nurse is caring for a client who is receiving a fluoroquinolone as an intravenous infusion. The nurse would check the infusion rate at which frequency?
- A. Every 15 minutes
- B. Every 30 minutes
- C. Every 45 minutes
- D. Every 60 minutes
Correct Answer: A
Rationale: When administering a fluoroquinolone IV, the nurse should check the infusion rate every 15 minutes and adjust it if necessary.
A client is receiving a fluoroquinolone as an extended-release formulation. Which of the following would be most important to include in the client's teaching plan?
- A. To chew, crush, or break the medication
- B. To swallow the medication whole
- C. To limit the daily fluid intake
- D. To take the drug with an antacid
Correct Answer: B
Rationale: When an extended-release formulation is prescribed, the client needs instructions to swallow the medication whole and not to chew, crush, or break the medication. Otherwise, the amount of drug released would be too great for the body all at once Clients should be encouraged to increase their fluid intake and to separate administration by 1 to 2 hours.
Prior to administration of moxifloxacin (Avelox), a nurse obtains a medication history. Use of which drug would alert the nurse to contact the prescriber because concomitant use would lead to an increased risk for a severe cardiac arrhythmia? Select all that apply.
- A. Amiodarone (Pacerone)
- B. Glyburide (DiaBeta)
- C. Solaid (Betapace)
- D. Procainamide (Procanbid)
- E. Ibuprofen (Motrin)
Correct Answer: A,C,D
Rationale: There is a risk of severe cardiac arrhythmias when moxifloxacin (Avelox) is administered with drugs that increase the QT interval, such as quinidine, procainamide, amiodarone, or sotalol.