A nurse is caring for a patient who has been prescribed metronidazole. The patient has elevated alanine transaminase (ALT) and aspartate transaminase (AST). What action should the nurse take concerning the administration of metronidazole to this patient?
Monitor the patient closely during administration.
Avoid giving metronidazole to the patient.
Reduce the metronidazole dose to half of the prescribed amount.
Administer metronidazole as prescribed.
The Correct Answer is B
Choice A reason: Monitoring alone is insufficient with elevated ALT and AST, indicating liver dysfunction. Metronidazole is metabolized by the liver, and hepatotoxicity is a known risk. Administering it to a patient with pre-existing liver damage could worsen hepatic injury, making this action inadequate.
Choice B reason: Elevated ALT and AST suggest liver dysfunction, and metronidazole, metabolized hepatically, can exacerbate hepatotoxicity. Avoiding administration prevents further liver damage, as the drug’s nitroimidazole structure undergoes hepatic reduction, producing toxic metabolites that stress an already compromised liver, necessitating alternative therapy.
Choice C reason: Reducing the metronidazole dose is not recommended without medical consultation. Elevated liver enzymes indicate impaired hepatic function, and even reduced doses may worsen hepatotoxicity. Alternative antibiotics with less hepatic metabolism should be considered, making dose reduction an unsafe choice.
Choice D reason: Administering metronidazole as prescribed is dangerous with elevated ALT and AST, signaling liver dysfunction. Metronidazole’s hepatic metabolism can exacerbate liver injury, increasing the risk of severe hepatotoxicity. The nurse should withhold the drug and consult the prescriber for safer alternatives.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Fluticasone propionate, an inhaled corticosteroid, reduces airway inflammation over days, not suitable for acute asthma or COPD exacerbations. Its slow onset targets chronic control, not immediate bronchodilation, making it ineffective for rapid relief of acute bronchospasm or worsening respiratory symptoms.
Choice B reason: Salmeterol, a long-acting beta-2 agonist, provides sustained bronchodilation (12 hours) for maintenance therapy. Its slow onset (20-30 minutes) makes it unsuitable for acute asthma or COPD exacerbations, where rapid-acting agents like albuterol are needed for immediate airway relaxation.
Choice C reason: Albuterol, a short-acting beta-2 agonist, has a rapid onset (within minutes) by stimulating beta-2 receptors, increasing cyclic AMP, and relaxing airway smooth muscle. This makes it the first-line choice for acute asthma attacks or COPD exacerbations, providing quick relief of bronchospasm and dyspnea.
Choice D reason: Zafirlukast, a leukotriene receptor antagonist, prevents inflammation and bronchoconstriction for asthma maintenance. Its oral administration and slow onset (hours) make it ineffective for acute asthma or COPD exacerbations, which require rapid bronchodilation from inhalers like albuterol, not leukotriene modifiers.
Correct Answer is B
Explanation
Choice A reason: Delayed growth development is not a primary adverse effect of tetracycline in children. Tetracyclines inhibit protein synthesis and may affect bone growth minimally, but this is not well-documented. Their primary concern in children under 8 is tooth discoloration, making this incorrect.
Choice B reason: Tetracycline use in children under 8 causes permanent tooth discoloration by binding to calcium in developing teeth, forming a yellow-gray stain. This occurs during tooth enamel formation, making it a significant adverse effect, as the discoloration is irreversible, requiring cosmetic dental intervention.
Choice C reason: Drug-induced neurotoxicity is not a common effect of tetracycline. While tetracyclines can cause rare side effects like intracranial hypertension, neurotoxicity is more associated with drugs like aminoglycosides. Tooth discoloration is the primary concern in children, making this an incorrect choice.
Choice D reason: Gastrointestinal and rectal bleeding are not typical tetracycline side effects. Tetracyclines may cause gastrointestinal upset, like nausea, but bleeding is more associated with anticoagulants or NSAIDs. In children, tooth discoloration is the most significant adverse effect, making this choice incorrect.
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