A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?
Notify the healthcare provider of the contraindication to tetracyclines.
Advise the client that the oral birth control will be less effective while taking doxycycline hyclate.
Instruct the client to take the two medications at least two hours apart.
Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate
The Correct Answer is B
A) Notify the healthcare provider of the contraindication to tetracyclines: Tetracyclines, including doxycycline hyclate, are not contraindicated in clients taking birth control pills. While there may be interactions between these medications, they are not absolute contraindications.
B) Advise the client that the oral birth control will be less effective while taking doxycycline hyclate: Doxycycline hyclate, like other antibiotics, may reduce the effectiveness of oral contraceptives by altering the gut flora and interfering with the enterohepatic circulation of estrogen. Clients should be informed of this potential interaction and advised to use an additional form of contraception (such as condoms) while taking the antibiotic and for a period afterward.
C) Instruct the client to take the two medications at least two hours apart: While separating the administration of doxycycline hyclate and oral contraceptives by two hours may reduce the potential for interaction, it is not the standard recommendation. It is generally advised to use additional contraceptive methods during antibiotic therapy and for a period afterward, rather than relying solely on timing of medication administration.
D) Encourage the client to stop taking oral birth control until she has finished taking all the doxycycline hyclate: Stopping oral contraceptives abruptly is not recommended and may lead to unintended pregnancy. Instead, clients should be advised to use additional contraceptive methods while taking doxycycline hyclate and for a period afterward to ensure continued protection against pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) A serum creatinine level of 1.0 mg/dL falls within the reference range (0.5 to 1.1 mg/dL) and does not indicate immediate action by the nurse. Creatinine levels within the reference range suggest normal kidney function.
B) A platelet count of 100,000/mm3 (100 x 10^9/L) is below the lower limit of the reference range (150,000 to 400,000/mm3). Thrombocytopenia, or low platelet count, increases the risk of bleeding complications, especially when administering anticoagulants like enoxaparin. Therefore, a platelet count of 100,000/mm3 requires immediate action by the nurse to assess for bleeding and notify the healthcare provider.
C) A hematocrit of 45% (0.45 volume fraction) falls within the reference range (42% to 52%) and does not indicate immediate action by the nurse.
D) A blood urea nitrogen (BUN) level of 20 mg/dL (7.1 mmol/L) falls within the reference range (10 to 20 mg/dl) and does not indicate immediate action by the nurse.
Correct Answer is C
Explanation
A) Assessing for orthostatic hypotension is important when administering medications that can lower blood pressure, but in this scenario, the vital signs indicate bradycardia (heart rate of 48 beats/minute), which may be a contraindication for administering labetalol. Therefore, withholding the dose and notifying the healthcare provider is the priority.
B) Administering the dose and monitoring the client's blood pressure regularly could potentially worsen bradycardia and hypotension, especially given the client's current vital signs. It is safer to withhold the dose and seek guidance from the healthcare provider.
C) Withholding the scheduled dose and notifying the healthcare provider is the most appropriate action in this situation. The client's bradycardia, along with the hypertension, raises concern about the safety of administering labetalol without further assessment and possible adjustment of the treatment plan.
D) Applying a telemetry monitor may be warranted if the client's bradycardia is of concern, but it does not address the potential risk associated with administering labetalol to a client with a heart rate of 48 beats/minute. The priority is to withhold the medication and inform the healthcare provider for further evaluation and guidance.
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