A nurse is caring for a client.

Exhibits

After reviewing the information in the client's medical record, which of the following provider prescriptions should the nurse anticipate?

Complete the following sentence by using the list of options.

The nurse should anticipate a provider prescription for

___

as evidenced by the client's

___

.

A) Black-colored stools:
Black-colored stools are often a sign of gastrointestinal bleeding, particularly if the stool has a tarry appearance. This is not a common or expected side effect of rifampin. While rifampin can cause a variety of side effects, black stools are more commonly associated with gastrointestinal conditions or medications that irritate the stomach or gastrointestinal tract, such as iron supplements or nonsteroidal anti-inflammatory drugs (NSAIDs). Therefore, black stools should be investigated further and are not a typical reaction to rifampin.

B) Orange-colored secretions:
Rifampin is known to cause a harmless but notable side effect: the discoloration of bodily fluids, including urine, sweat, saliva, and tears, turning them a bright orange or red color. This is a well-known effect of the drug and is typically harmless, although it can be alarming for the patient. Patients should be instructed about this effect, especially for things like wearing contact lenses (which can be stained) and avoiding staining clothes. This is the most appropriate and expected clinical manifestation to inform the patient about.

C) Staining of teeth:
Staining of teeth is not a common side effect of rifampin. Although some antibiotics, such as tetracyclines, are associated with tooth discoloration (especially in children), rifampin is not known to cause staining of the teeth. This side effect is not typically seen in patients taking rifampin for tuberculosis or other infections.

D) Constipation:
Constipation is not a typical or common side effect of rifampin. While gastrointestinal side effects like nausea, vomiting, and abdominal discomfort can occur, constipation is not one of the expected reactions. Rifampin is more likely to cause digestive upset rather than constipation. If constipation occurs, it is more likely related to other factors such as diet, hydration, or other medications, rather than being directly caused by rifampin.

A) Retinal toxicity:
Chloroquine (Aralen), an antimalarial medication, is known to cause retinal toxicity, especially when used for prolonged periods or at high doses. Retinal toxicity can lead to damage to the retina, resulting in visual disturbances, blurred vision, and potentially permanent vision loss. This is a well-known adverse effect of chloroquine, and it is particularly concerning with long-term use. Patients taking chloroquine should be monitored regularly for signs of retinal damage, and baseline and periodic eye exams are recommended to assess for any changes in vision. Educating the client about the potential risk of retinal toxicity is important so they can report any visual disturbances promptly.

B) Nephrotoxicity:
Nephrotoxicity (kidney damage) is not a common adverse effect of chloroquine. While chloroquine can be excreted through the kidneys, it does not typically cause direct nephrotoxicity. However, renal function should be monitored in patients with pre-existing kidney disease, as dose adjustments may be necessary in such cases. In general, nephrotoxicity is not a primary concern with chloroquine, unlike other medications that are more commonly associated with kidney damage.

C) Hepatotoxicity:
While some antimalarial medications, such as atovaquone-proguanil or mefloquine, may have hepatotoxic effects, hepatotoxicity is not a common or significant adverse effect of chloroquine. However, like any medication, chloroquine should be used with caution in patients with liver disease, as liver dysfunction may affect the drug's metabolism. Nonetheless, hepatotoxicity is not a primary adverse effect to focus on for chloroquine use in the treatment of malaria.

D) Pancytopenia:
Pancytopenia, which refers to a reduction in all three blood cell types (red blood cells, white blood cells, and platelets), is not a common or expected adverse effect of chloroquine. While some antimalarial drugs may cause hematologic issues, such as agranulocytosis or thrombocytopenia, chloroquine is more commonly associated with gastrointestinal symptoms, skin reactions, and ocular toxicity. Pancytopenia is a rare and more serious adverse effect typically linked with other drugs, such as certain chemotherapeutic agents or immunosuppressants, rather than chloroquine.