The nurse is teaching a client and his family about administering pentamidine at home. Which statement by the client indicates a need for additional teaching?
- A. I should protect the solution from direct light.
- B. The entire treatment should take no more than 15 minutes.
- C. I need to dissolve the drug in the correct amount of sterile water.
- D. Only the pentamidine solution should go into the nebulizer's reservoir.
Correct Answer: B
Rationale: The pentamidine treatment typically lasts about 30 to 45 minutes. The solution should be protected from light after the drug is dissolved with the proper amount of sterile water. No other drugs should be added to the reservoir.
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Which of the following should be included in the teaching plan when instructing a female client on the use of miconazole (Monistat) vaginal cream?
- A. Discontinue drug during the menstrual period.
- B. Avoid nylon and tight-fitting garments to avoid reinfection.
- C. Wear a sanitary napkin after insertion to prevent staining of clothes and bed linens.
- D. Do not have intercourse while taking the drug to avoid reinfection.
- E. If there is no improvement in 2 days, stop using the drug and consult a physician.
Correct Answer: B,C,D
Rationale: When instructing a female client on the use of miconazole (Monistat) vaginal cream, the nurse should include the following: inserting the drug high in the vagina using the applicator provided: wearing a sanitary napkin after insertion of the drug to prevent staining of clothes and bed linens; continuing the drug during the menstrual period; not having intercourse while taking the drug or advising her partner to use a condom to avoid reinfection; avoiding nylon and tight-fitting garments to avoid reinfection; stopping the drug and notifying the primary health care provider if there is no improvement in 5 to 7 days; and if abdominal pain, pelvic pain, rash, fever, or offensive-smelling vaginal discharge is present, not using the drug but notifying the physician.
Which of the following would the nurse include in the teaching plan as an adverse reaction for a client receiving antihelminthic therapy?
- A. Hypotension
- B. Drowsiness
- C. Abdominal pain
- D. Hypoglycemia
- E. Nausea
Correct Answer: B,C,E
Rationale: Antihelminthics cause several generalized adverse reactions that the client should be advised of, including drowsiness, dizziness, nausea, vomiting, abdominal pain and cramps, and diarrhea.
After teaching a group of nursing students about antiprotozoal drugs, the instructor determines that the teaching was successful when the group identifies which of the following as an indication for use?
- A. Toxoplasmosis
- B. Malaria
- C. Giardiasis
- D. Pneumocystis carinii pneumonia
- E. Trichomoniasis
Correct Answer: A,B,C,D,E
Rationale: Antiprotozoal drugs are used in the treatment of malaria, giardiasis, toxoplasmosis, intestinal amebiasis, trichomoniasis, and Pneumocystis carinii pneumonia.
A client is planning to travel to an area of the world where malaria is endemic. The physician has given the client a prescription of chloroquine as prophylaxis. Which of the following would the nurse include in the teaching plan for this client about starting and ending therapy?
- A. Begin therapy 1 month before exposure.
- B. Begin therapy 2 weeks before exposure.
- C. Continue therapy 6 to 8 weeks after leaving endemic area.
- D. Continue therapy 1 to 2 weeks after leaving endemic area.
- E. Stop therapy 2 days prior to leaving endemic area.
Correct Answer: B,C
Rationale: The nurse should advise the client to begin malaria prophylaxis therapy 2 weeks before traveling to the endemic area and to continue therapy 6 to 8 weeks after leaving the endemic area.
A client is receiving amphotericin B IV. The nurse identifies a nursing diagnosis of Impaired Comfort related to medication administration. The nurse determines that the plan of care was effective when which outcome is achieved?
- A. Client remains free from rigors.
- B. Client exhibits a blood pressure within acceptable parameters.
- C. Client maintains a patent IV infusion site.
- D. Client maintains a urine output of at least 30 mL/hour.
- E. Client demonstrates procedure for cleaning involved area.
Correct Answer: A,B,C
Rationale: The patient receiving amphotericin B IV can experience rigors, hypotension, and problems with the IV infusion site. Therefore, remaining free from rigors and maintaining a stable blood pressure and a patent IV infusion site would indicate that the plan of care for impaired comfort is successful. A urine output of 30 mL/hour would be an indicator of adequate renal tissue perfusion. Cleaning the involved area would not be appropriate because the client has a systemic fungal infection.
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