A client with AIDS has an order to start Amphotericin B. Which intervention should the nurse implement first?
Administer the drug as an IV piggyback with another drug.
Check the client's serum calcium levels
Administer a test dose of 1 mg, over 30 minutes
Administer an absorbate antidiarrheal medication 30 minutes prior to administration.
The Correct Answer is C
A. Administer the drug as an IV piggyback with another drug.: Amphotericin B should never be mixed or administered with other medications in the same IV line because it is incompatible with many drugs. Doing so could lead to precipitation or reduced drug potency.
B. Check the client's serum calcium levels.: While electrolyte monitoring is important during therapy, amphotericin B primarily causes hypokalemia and hypomagnesemia rather than significant calcium changes. Checking calcium is not the immediate priority.
C. Administer a test dose of 1 mg, over 30 minutes.: Amphotericin B is highly nephrotoxic and can cause severe hypersensitivity reactions such as fever, chills, hypotension, or anaphylaxis. Administering a small test dose first allows the nurse to assess the client’s tolerance and detect potential adverse reactions before giving the full therapeutic dose.
D. Administer an absorbate antidiarrheal medication 30 minutes prior to administration.: Amphotericin B is not associated with diarrhea as a major side effect. The focus should instead be on test dosing, prehydration, and monitoring for infusion reactions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Decreased urine output.: A reduction in urine output is a critical finding because gentamicin is nephrotoxic and can cause acute kidney injury by damaging renal tubule cells. Early signs of nephrotoxicity include oliguria, increased serum creatinine, and elevated BUN levels.
B. Mild nausea.: Nausea is a relatively common and mild side effect of many antibiotics, including gentamicin. It does not usually indicate toxicity and can often be managed with supportive care or by adjusting administration timing.
C. Slightly elevated heart rate.: A mild increase in heart rate may occur due to infection, fever, or stress, but it is not directly linked to gentamicin toxicity. The nurse should continue to monitor vital signs but prioritize assessment of renal and auditory function.
D. Headache.: Headache can occur with antibiotic therapy or as a symptom of infection but is generally not an urgent finding. The primary toxicities are nephrotoxicity and ototoxicity, making renal assessment findings such as decreased urine output the highest priority.
Correct Answer is D
Explanation
A. "If the medicine causes an upset stomach, take an antacid at the same time.": Ciprofloxacin should not be taken with antacids containing magnesium or aluminum because these reduce the medication’s absorption and effectiveness.
B. "Limit your daily fluid intake while taking this medication.": Clients should be encouraged to increase, not limit, fluid intake when taking ciprofloxacin. Adequate hydration helps prevent crystalluria and protects renal function.
C. "This medication will affect your eyesight, wear sunglasses while outside.": Ciprofloxacin does not typically cause vision changes or photosensitivity requiring sunglasses. It is not a significant or common side effect of quinolones.
D. "You should report any discomfort in your tendons while taking this medication.": Ciprofloxacin carries a risk for tendinitis and tendon rupture, especially in older adults and those taking corticosteroids. Reporting tendon pain early allows the healthcare provider to discontinue the drug and prevent permanent tendon damage.
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