Nokea
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.
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A client is receiving a fluoroquinolone as an extended-release formulation. Which of the following would be most important to include in the client's teaching plan?
- A. To chew, crush, or break the medication
- B. To swallow the medication whole
- C. To limit the daily fluid intake
- D. To take the drug with an antacid
Correct Answer: B
Rationale: When an extended-release formulation is prescribed, the client needs instructions to swallow the medication whole and not to chew, crush, or break the medication. Otherwise, the amount of drug released would be too great for the body all at once Clients should be encouraged to increase their fluid intake and to separate administration by 1 to 2 hours.
Prior to administration of moxifloxacin (Avelox), a nurse obtains a medication history. Use of which drug would alert the nurse to contact the prescriber because concomitant use would lead to an increased risk for a severe cardiac arrhythmia? Select all that apply.
- A. Amiodarone (Pacerone)
- B. Glyburide (DiaBeta)
- C. Solaid (Betapace)
- D. Procainamide (Procanbid)
- E. Ibuprofen (Motrin)
Correct Answer: A,C,D
Rationale: There is a risk of severe cardiac arrhythmias when moxifloxacin (Avelox) is administered with drugs that increase the QT interval, such as quinidine, procainamide, amiodarone, or sotalol.
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.
A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and the client receives intravenous fluids and protein supplementation. The physician prescribes medication as part of the treatment plan. The nurse would expect to administer which of the following?
- A. Fidaxomicin
- B. Metronidazole
- C. Norfloxacin
- D. Moxifloxacin
Correct Answer: A
Rationale: Moderate to severe cases of pseudomembranous colitis may require treatment with intravenous (IV) fluids and electrolytes, protein supplementation, and treatment with drugs such as fidaxomicin (Dificid) to eliminate the microorganism. Metronidazole is used to treat infections involving anaerobic organisms. Norfloxacin and moxifloxacin are fluoroquinolones and would not be used.
During ongoing assessment of clients taking fluoroquinolone, which of the following adverse reactions should be reported to the physician immediately? Select all that apply.
- A. Respiratory difficulty
- B. Drowsiness
- C. Severe diarrhea
- D. Hypersensitivity reaction
- E. A significant drop in blood pressure
Correct Answer: A,C,D,E
Rationale: It is important for the nurse to report any adverse reaction to the physician prior to administering the next dose but the nurse should notify the physician immediately if respiratory difficulty, hypersensitivity reaction, severe diarrhea, or a decided drop in blood pressure occurs.