Nokea
The nurse must monitor a client carefully for signs of bleeding when which of the following antifungals is concomitantly administered with warfarin (Coumadin)?
- A. Fluconazole (Diflucan)
- B. Itraconazole (Sporanox)
- C. Ketoconazole (Nizoral)
- D. Griseofulvin (Grisactin)
- E. Voriconazole (Vfend)
Correct Answer: A,B,C,D,E
Rationale: The concomitant administration of fluconazole, itraconazole, ketoconazole, griseofulvin, and voriconazole with warfarin increases the client's risk of bleeding.
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A patient has been prescribed albendazole on an outpatient basis for an anthelmintic infection. After teaching the patient about the therapy, which statement by the patient indicates effective teaching?
- A. Easy bruising or bleeding is normal and neednt be reported.
- B. I need to disinfect the bathtub or shower stall immediately after bathing.
- C. I should avoid bathing daily if I have problems with my skin.
- D. I need to use oral contraceptives while I'm taking this drug.
Correct Answer: B
Rationale: The nurse should instruct the patient to disinfect the bathtub or shower stall immediately after bathing to avoid spreading the infection. Thrombocytopenia or easy bruising or bleeding is not normal and should be reported immediately. Impaired skin integrity is not associated with albendazole, so there is no need to avoid bathing daily. Instead of oral contraceptives, the nurse should recommend the barrier method during the course of therapy and for 1 month after discontinuing the therapy.
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.
During treatment of parasitic infections, the primary health care provider orders daily stool specimens be sent to the lab for examination. Which of the following would the nurse document as part of the client's plan of care?
- A. Number of stools produced
- B. Odor of stool
- C. Consistency of stool
- D. Frequency of stool
- E. Color of stool
Correct Answer: A,C,D,E
Rationale: The nurse should record the number, consistency, color, and frequency of stools as part of the client's plan of care. Documenting the odor is not necessary.
A client who is receiving oral systemic antifungal therapy has a nursing diagnosis of Risk for Ineffective Renal Tissue Perfusion. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Monitoring urine output hourly
- B. Monitoring serum creatinine levels
- C. Evaluating blood urea nitrogen levels
- D. Premedicating the client with an antihistamine
Correct Answer: D
Rationale: For the nursing diagnosis of ineffective renal tissue perfusion, the nurse would monitor the client's urine output hourly and evaluate serum creatinine and BUN levels frequently. Premedicating the client with an antihistamine would only be appropriate if the client was receiving amphotericin B via IV infusion.
A patient has been prescribed ketoconazole. Which of the following instructions should the nurse give to the patient regarding its use?
- A. Cut the tablet in half and take each half one after the other.
- B. Take the drug with an antacid.
- C. Ignore any abdominal pain and fever-these are normal.
- D. Do not drive if drowsiness or dizziness occurs.
Correct Answer: D
Rationale: The nurse should instruct the patient to avoid driving or performing other hazardous tasks requiring alertness if drowsiness or dizziness occurs. The tablet should not be cut in two or chewed. The drug should also not be taken with an antacid because of a decrease in absorption. Abdominal pain and fever should be reported to the primary health care provider immediately, not ignored.