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.
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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 group of nursing students are reviewing information about fluoroquinolones. The students demonstrate understanding of the information when they identify that an empty stomach is essential for the administration of which drug?
- A. Ciprofloxacin
- B. Moxifloxacin
- C. Levofloxacin
- D. Norfloxacin
Correct Answer: D
Rationale: Although any of the fluoroquinolones can be given on an empty stomach, it is essential that norfloxacin is given in such a manner.
A nurse is reviewing the signs and symptoms of a fungal superinfection with a client. The client demonstrates understanding of the information when he identifies which of the following as suggesting a fungal superinfection? Select all that apply.
- A. Bloody diarrhea
- B. Abdominal cramping
- C. Creamy white patches on the throat
- D. Intense vaginal itching
- E. Excoriation of the anogenital skin folds
Correct Answer: C,D,E
Rationale: A fungal superinfection commonly occurs in the mouth, vagina, and anogenital areas, commonly manifested by creamy, white, lace-like patches on the tongue, mouth, or throat; white or yellow vaginal discharge; anal or vaginal itching or redness; and inflammation or excoriation of the mouth or the skin folds of the anogenital area. Bacterial superinfections commonly occur in the bowel, manifested by fever, diarrhea with visible blood or mucus, and abdominal cramping.
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.
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.
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