A nurse is preparing to administer an antimicrobial agent to a patient who has a urinary tract infection. The nurse reviews the culture and sensitivity results and notes that the microorganism is resistant to the prescribed antimicrobial agent.
What is the most appropriate action by the nurse?
Administer the antimicrobial agent as ordered and monitor for therapeutic effects.
Hold the antimicrobial agent and notify the prescriber of the resistance.
Administer a different antimicrobial agent that is sensitive to the microorganism.
Administer the antimicrobial agent with another medication to enhance its activity.
The Correct Answer is B
Hold the antimicrobial agent and notify the prescriber of the resistance. This is because administering an antimicrobial agent that the microorganism is resistant to will not be effective and may increase the risk of medication toxicity. The prescriber should be informed so that they can order a different antimicrobial agent that is sensitive to the microorganism.
Choice A is wrong because administering the antimicrobial agent as ordered and monitoring for therapeutic effects will not treat the urinary tract infection (UTI) and may allow the infection to spread or worsen.
Choice C is wrong because administering a different antimicrobial agent that is sensitive to the microorganism without consulting the prescriber is outside the nurse’s scope of practice and may cause adverse effects or interactions.
Choice D is wrong because administering the antimicrobial agent with another medication to enhance its activity without consulting the prescriber is also outside the nurse’s scope of practice and may not be appropriate for the type of microorganism causing the UTI.
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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