Nokea
The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.)
- A. Opioids
- B. Oral contraceptives
- C. Sulfonylureas
- D. Antihistamines
- E. Phenytoin
- F. Warfarin
Correct Answer: B,C,E,F
Rationale: Sulfonamides may potentiate the hypoglycemic effects of sulfonylureas in diabetes treatment and the toxic effects of phenytoin. They also enhance the anticoagulant effects of warfarin, which can lead to hemorrhage. Sulfonamides may also reduce the efficacy of oral contraceptives. Opioids and antihistamines are not typically associated with significant interactions with sulfonamides.
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A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling anxious and is having trouble breathing. What will the nurse do first?
- A. Notify the prescriber.
- B. Take the patient's vital signs.
- C. Stop the antibiotic infusion.
- D. Check for allergies.
Correct Answer: C
Rationale: Hypersensitivity reactions are characterized by wheezing; shortness of breath; swelling of the face, tongue, or hands; itching; or rash. The nurse should immediately stop the antibiotic infusion, have someone notify the prescriber, and stay with the patient to monitor the patient's vital signs and condition. Checking for allergies should have been done before the infusion.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101?°F (38.3?°C). Based on these findings, which conclusion will the nurse draw?
- A. The patient's original infection has not responded to the antibiotic therapy.
- B. The patient is showing typical adverse effects of antibiotic therapy.
- C. The patient needs to be tested for Clostridium difficile infection.
- D. The patient will need to take a different antibiotic.
Correct Answer: C
Rationale: Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a serious superinfection when it causes antibiotic-associated colitis, also known as pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever.
A patient with a long-term intravenous catheter is going home. The nurse knows that if the patient is allergic to seafood, which antiseptic agent is contraindicated?
- A. Chlorhexidine gluconate
- B. Hydrogen peroxide
- C. Povidone-iodine
- D. Isopropyl alcohol
Correct Answer: C
Rationale: Iodine compounds are contraindicated in patients with allergies to seafood.
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?
- A. Avoid direct sunlight and tanning beds while on this medication.
- B. Milk and cheese products result in increased levels of tetracycline.
- C. Antacids taken with the medication help to reduce gastrointestinal distress.
- D. Take the medication until you are feeling better.
Correct Answer: A
Rationale: Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for several days after therapy. Milk and cheese products result in decreased levels of tetracycline when the two are taken together. Antacids also interfere with absorption and should not be taken with tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if they feel that they are no longer ill.
The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?
- A. First-generation
- B. Second-generation
- C. Third-generation
- D. Fourth-generation
Correct Answer: A
Rationale: First-generation cephalosporins provide excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria.