A nurse is caring for a client who has tuberculosis and is receiving isoniazid (INH), rifampin (Rifadin), pyrazinamide (PZA), and ethambutol (Myambutol).
The nurse monitors the client’s liver function tests and advises the client to avoid which substance while taking these drugs?

Elevated serum creatinine and decreased urine output are signs of nephrotoxicity, which is a potential adverse effect of vancomycin (Vancocin) therapy. Nephrotoxicity is damage to the kidneys caused by toxic substances.

Choice C is wrong because increased blood pressure is not a sign of nephrotoxicity.Hypotension may occur during vancomycin infusion, especially if it is given too rapidly.

Choice D is wrong because hematuria is not a sign of nephrotoxicity.

Hematuria is blood in the urine, which may indicate other problems such as urinary tract infection, kidney stones, or bladder cancer.

Choice E is wrong because tinnitus is not a sign of nephrotoxicity.Tinnitus is ringing or buzzing in the ears, which may indicate ototoxicity, another potential adverse effect of vancomycin therapy.

Ototoxicity is damage to the ears caused by toxic substances.

Normal ranges for serum creatinine are 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.

Normal ranges for urine output are 800 to 2000 mL per day or 30 to 50 mL per hour.

The nurse should avoid administering macrolides to this client because they have a history of allergic reactions to penicillins, cephalosporins, sulfonamides, and fluoroquinolones.Macrolides are a class of antibiotics that have a similar structure and mechanism of action to penicillins and cephalosporins.Therefore, there is a risk of cross-reactivity and hypersensitivity reactions between these antibiotics.

Choice B is wrong because Tetracyclines is wrong because tetracyclines are a class of antibiotics that have a different structure and mechanism of action from penicillins, cephalosporins, sulfonamides, and fluoroquinolones.They are not likely to cause cross-reactivity or hypersensitivity reactions in this client.

Choice C is wrong because Aminoglycosides is wrong because aminoglycosides are a class of antibiotics that have a different structure and mechanism of action from penicillins, cephalosporins, sulfonamides, and fluoroquinolones.They are not likely to cause cross-reactivity or hypersensitivity reactions in this client.

Choice D is wrong because Glycopeptides is wrong because glycopeptides are a class of antibiotics that have a different structure and mechanism of action from penicillins, cephalosporins, sulfonamides, and fluoroquinolones.They are not likely to cause cross-reactivity or hypersensitivity reactions in this client.