A nurse is educating a client who has a respiratory infection and a new prescription for azithromycin (Zithromax).
Which of the following instructions should the nurse include? (Select all that apply).

Take the medication with or without food

Report any signs of jaundice or dark urine

Avoid drinking grapefruit juice while taking this medication

Complete the full course of therapy as prescribed

Store the medication in a cool and dry place.

Answer and Explanation

Correct Answer : B,C,D

Choice A is wrong because azithromycin (Zithromax) should be taken with food to prevent stomach upset.

Choice B is correct because azithromycin can cause liver damage and the client should report any signs of jaundice or dark urine as they may indicate liver problems.

Choice C is correct because azithromycin can interact with grapefruit juice and increase the risk of side effects such as nausea, vomiting, diarrhea, headache and QT interval prolongation.

Choice D is correct because the client should complete the full course of therapy as prescribed to prevent bacterial resistance and recurrence of infection.

Choice E is wrong because azithromycin should be stored in a refrigerator and discarded after 10 days if it is in a liquid form.

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Correct Answer is B

Explanation

This is because antibiotics act synergistically with the immune system to subdue infection, and it is critical for success that the host defenses are adequate.

Choice A is wrong becauseAge is wrong because age is a general factor that must be considered when choosing any medication, not just antimicrobials.

Choice C is wrong becauseGenetic heritage is wrong because genetic heritage is also a general factor that may affect the metabolism and excretion of medications, not the selection of antimicrobials.

Choice D is wrong becausePrevious medication reactions is wrong because previous medication reactions are also a general factor that may indicate allergies or intolerances to certain medications, not the selection of antimicrobials.

Normal ranges for immune function vary depending on the type and level of immunity measured, such as innate, adaptive, humoral or cellular immunity.Some common tests for immune function include complete blood count (CBC), immunoglobulin levels, complement levels, antibody titers and skin tests.

Normal ranges for these tests depend on the laboratory and the method used, but some examples are:

• CBC: white blood cell count 4.5-11 x 10^9/L; neutrophils 40-75%; lymphocytes 20-50%; monocytes 2-10%; eosinophils 1-6%; basophils 0-2%.

• Immunoglobulin levels: IgG 7-16 g/L; IgA 0.7-4 g/L; IgM 0.4-2.3 g/L; IgE 0-0.4 g/L.

• Complement levels: C3 0.9-1.8 g

A. Elevated serum creatinine level B. Decreased serum potassium level C. Increased serum glucose level D. Decreased white blood cell count.

Correct Answer is A

Explanation

This is because itraconazole can cause renal impairment and decreased urine output as an adverse effect.A normal serum creatinine level is 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females.

Choice B is wrong because decreased serum potassium level is not an adverse effect of itraconazole.Itraconazole can cause hypokalemia, which is a low level of potassium in the blood, but this is usually due to fluid retention and heart failure caused by the drug.A normal serum potassium level is 3.5 to 5.0 mEq/L.

Choice C is wrong because increased serum glucose level is not an adverse effect of itraconazole.Itraconazole can cause hyperglycemia, which is a high level of glucose in the blood, but this is usually due to diabetes mellitus or steroid use in patients taking the drug.A normal serum glucose level is 70 to 100 mg/dL.

Choice D is wrong because decreased white blood cell count is not an adverse effect of itraconazole.Itraconazole can cause leukopenia, which is a low level of white blood cells in the blood, but this is usually due to bone marrow suppression or infection in patients taking the drug.A normal white blood cell count is 4,500 to 11,000 cells/mm3.

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A nurse is educating a client who has a respiratory infection and a new prescription for azithromycin (Zithromax). Which of the following instructions should the nurse include? (Select all that apply).

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A nurse is educating a client who has a respiratory infection and a new prescription for azithromycin (Zithromax).
Which of the following instructions should the nurse include? (Select all that apply).