A 2 month old patient with current active infection. Being treated with Neomycin.

The nurse understands that neomycin may cause serious adverse effects such as 

___

and

___

.

A) This medication should be taken with antacids to prevent gastrointestinal distress:
Antacids should not be taken with ferrous sulfate because they can reduce the absorption of iron. Antacids contain calcium, magnesium, and aluminum, which can bind to iron and decrease its effectiveness. Iron should be taken on an empty stomach when possible to enhance absorption, though some individuals may take it with food to reduce gastrointestinal discomfort, but antacids are not recommended in combination with iron therapy.

B) This medication should be taken with a straw to avoid discoloration of the teeth:
Iron supplements, including ferrous sulfate, can stain teeth if they come into direct contact with them, especially in liquid form. To minimize the risk of staining, it is advisable to take the medication using a straw, which helps prevent the liquid from touching the teeth. After taking the supplement, it's also a good idea to rinse the mouth with water or brush the teeth to further reduce the risk of staining. This is a common recommendation for patients on liquid iron supplements.

C) This medication is to be taken with milk to enhance absorption:
Milk actually inhibits the absorption of iron because it contains calcium, which binds to iron and prevents it from being absorbed effectively. To maximize iron absorption, it is recommended to take ferrous sulfate with a source of vitamin C (like orange juice) instead of milk. Vitamin C helps increase the absorption of non-heme iron, which is found in supplements like ferrous sulfate.

D) This medication is to be taken at night to prevent constipation from occurring:
Iron supplementation is commonly associated with constipation, which is a common side effect. Taking iron at night does not necessarily prevent constipation and may cause discomfort during the day due to delayed effects. It is typically recommended to take iron supplements during the day, but with food (if gastrointestinal distress occurs). Other strategies, such as increasing fiber intake or using stool softeners, can help manage constipation. Taking iron at night does not specifically address this issue.

i) Prophylactic: The cefazolin administered prior to the colonoscopy was intended to prevent potential infection related to the surgical procedure. Prophylactic antibiotics are given to reduce the risk of postoperative infections in patients undergoing surgeries, especially those involving the gastrointestinal tract.

ii) Empiric: The ampicillin/sulbactam prescribed post-procedure is used empirically to treat the diverticular abscess while awaiting culture results. Empiric therapy is based on clinical judgment to target likely pathogens before specific culture data are available, ensuring timely treatment of the infection.

Incorrect:

Curative: Refers to treatment aimed at eradicating a disease, not applicable to the initial prophylactic dose or empirical use of antibiotics.

Therapeutic: Broadly refers to treatment, but in this context, "empiric" more precisely describes the rationale for antibiotic use.

Diagnostic: Involves tests or procedures to determine a diagnosis, not relevant to the use of antibiotics.

Adjunctive: Refers to supplementary treatment, which does not describe the primary role of the antibiotics.

Maintenance: Involves ongoing treatment to prevent recurrence, which is not relevant here.