A nurse is educating a patient about the adverse effects of antimicrobial therapy.
Which of the following statements by the patient indicate a need for further teaching? (Select all that apply.)
“I will drink plenty of fluids to prevent kidney damage.”
“I will report any ringing in my ears or hearing loss.”
“I will use sunscreen and wear protective clothing when outdoors.”
“I will stop taking the medication if I develop a rash or hives.”
“I will take an antacid if I have stomach upset."
Correct Answer : D,E
The correct answer is choice D and E and they indicate a need for further teaching.
Choice D is wrong because the patient should not stop taking the medication if they develop a rash or hives, but should report it to the provider immediately, as this could indicate a serious allergic reaction.
Choice E is wrong because the patient should not take an antacid if they have stomach upset, as this could interfere with the absorption of the antimicrobial drug.
Some additional information:
• Choice A is correct because drinking plenty of fluids can help prevent kidney damage from some antimicrobial drugs, such as aminoglycosides.
• Choice B is correct because ringing in the ears or hearing loss can be signs of ototoxicity from some antimicrobial drugs, such as vancomycin.
• Choice C is correct because some antimicrobial drugs, such as tetracyclines and sulfonamides, can increase the sensitivity to sunlight and cause sunburns.
• Normal ranges for kidney function tests are blood urea nitrogen (BUN) 7 to 20 mg/dL and creatinine 0.6 to 1.2 mg/dL.
• Normal ranges for liver function tests are alanine aminotransferase (ALT) 7 to 56 units/L and aspartate aminotransferase (AST) 10 to 40 units/L.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The patient should avoid consuming alcohol while taking metronidazole, a nitroimidazole antibiotic, for a bacterial infection.This is because the combination of metronidazole and alcohol can cause a reaction (often referred to as a disulfiram-like reaction) in some people that may include nausea, vomiting, flushing, fast heart beat, and stomach cramps.This reaction can be severe and even fatal.It is best to avoid alcohol while taking metronidazole and for at least 3 days after the last dose.
Choice A is wrong because grapefruit juice does not interact with metronidazole.
Choice B is wrong because dairy products do not interact with metronidazole.
Choice D is wrong because caffeine does not interact with metronidazole.
Correct Answer is B
Explanation
Gentamicin is an aminoglycoside antibiotic that can cause nephrotoxicity, which is the damage of the kidney.Gentamicin induces nephrotoxicity by inhibiting protein synthesis in renal cells that specifically causes necrosis of cells in the renal proximal tubule, resulting in acute tubular necrosis, followed by acute renal failure.The nurse monitors the patient’s serum creatinine level as an indicator of nephrotoxicity because serum creatinine reflects the glomerular filtration rate (GFR) and kidney function.
Choice A is wrong because hepatotoxicity is the damage of the liver, not the kidney.
Gentamicin is not known to cause hepatotoxicity.
Choice C is wrong because neurotoxicity is the damage of the nervous system, not the kidney.
Gentamicin can cause neurotoxicity by affecting the neuromuscular junction and causing muscle weakness or paralysis, but this is not related to serum creatinine level.
Choice D is wrong because ototoxicity is the damage of the ear, not the kidney.
Gentamicin can cause ototoxicity by damaging the hair cells in the inner ear and causing hearing loss or balance problems, but this is not related to serum creatinine level.
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.
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