Nokea
The nurse is reviewing the medical records of several patients who are receiving fluoroquinolone therapy. Each of the patients is also receiving corticosteroid therapy. Which patient would the nurse identify as being at greatest risk for tendonitis?
- A. 34-year-old female
- B. 22-year-old male
- C. 45-year-old female
- D. 72-year-old male
Correct Answer: D
Rationale: Tendonitis and tendon rupture risk increase when taking a fluoroquinolone. Although this can happen at any age, those older than 60 years who also take corticosteroids are at greater risk.
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After teaching a group of nursing students about fluoroquinolones, the instructor determines that the teaching was successful when they identify which of the following as an example? Select all that apply.
- A. Levofloxacin (Levaquin)
- B. Amoxicillin (Amoxil)
- C. Cephalexin (Keflex)
- D. Spectinomycin (Trobicin)
- E. Ciprofloxacin (Cipro)
Correct Answer: A,E
Rationale: The fluoroquinolone drugs include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). Amoxicillin is an aminopenicillin. Spectinomycin is chemically related to but different from aminoglycosides.
Fluoroquinolones should be used with caution in which of the following clients? Select all that apply.
- A. Clients with diabetes
- B. Clients with hypertension
- C. Clients receiving dialysis
- D. Clients with chronic obstructive pulmonary disorder (COPD)
- E. Clients with epilepsy
Correct Answer: A,C,E
Rationale: Fluoroquinolones should be used with caution in clients with diabetes, renal impairment, or history of seizures, older clients, and clients on dialysis.
Which of the following information should the nurse obtain during the preadministration assessment of a client prescribed a fluoroquinolone? Select all that apply.
- A. Blood glucose levels
- B. Allergy history
- C. Signs and symptoms of infection
- D. Blood pressure
- E. Temperature
Correct Answer: B,C,D,E
Rationale: Before administering a fluoroquinolone, the nurse identifies and records the signs and symptoms of the infections, takes a thorough allergy history, takes and records vital signs, and, if ordered, obtains cultures.
A client is receiving a fluoroquinolone and is also taking ibuprofen for pain relief. The nurse would be alert for which of the following?
- A. Increased risk for bleeding
- B. Decreased effectiveness of the fluoroquinolone
- C. Increased risk for seizures
- D. Delayed elimination of the fluoroquinolone
Correct Answer: C
Rationale: When a nonsteroidal anti-inflammatory drug such as ibuprofen is used in conjunction with a fluoroquinolone, the patient has an increased risk for seizures. An increased risk of bleeding would occur with oral anticoagulants in conjunction with fluoroquinolone therapy. Decreased effectiveness of the fluoroquinolone would occur if it was given with antacids, iron salts, or zinc because of decreased absorption of the antibiotic. Cimetidine interferes with the elimination of the fluoroquinolone, leading to prolonged presence of the drug in the bloodstream.
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.