A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile.
The nurse should select all that apply:

Monitor the client’s serum creatinine level

Monitor the client’s serum vancomycin level

Infuse the drug over at least 60 minutes

Observe the client

Answer and Explanation

Correct Answer : A,B,C

Here is why:

• Choice A: Monitor the client’s serum creatinine level.

This is correct because vancomycin can cause nephrotoxicity (damage to the kidneys) and serum creatinine is a marker of kidney function. A high serum creatinine level indicates impaired kidney function and may require dose adjustment or discontinuation of vancomycin.

• Choice B: Monitor the client’s serum vancomycin level.

This is correct because vancomycin has a narrow therapeutic range, meaning that there is a small difference between the effective dose and the toxic dose. Monitoring the serum vancomycin level can help to ensure that the drug is within the therapeutic range and avoid toxicity or suboptimal efficacy.

• Choice C: Infuse the drug over at least 60 minutes.

This is correct because vancomycin can cause a hypersensitivity reaction called “red man syndrome” or “red neck syndrome”, which is characterized by flushing, itching, rash, hypotension and tachycardia.

This reaction is not an allergy but a result of histamine release due to rapid infusion of vancomycin. Infusing the drug over at least 60 minutes can reduce the risk of this reaction.

• Choice D: Observe the client for signs of ototoxicity.

This is incorrect because vancomycin is not known to cause ototoxicity (damage to the ears) in humans. Ototoxicity has been reported in animal studies and in vitro studies, but not in clinical trials or case reports involving humans.

Therefore, there is no need to monitor for signs of ototoxicity such as hearing loss, tinnitus or vertigo.

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Correct Answer is ["A","B"]

Explanation

Gentamicin is an aminoglycoside antibiotic that can causeototoxicity(damage to the inner ear) andnephrotoxicity(damage to the kidneys) as serious side effects. These effects may be irreversible and can occur even at therapeutic doses. Therefore, the nurse should monitor the client’s hearing, balance, urine output, and blood tests for kidney function while on this drug.

Choice C is wrong because gentamicin does not causehepatotoxicity(damage to the liver).

This is more common with other antibiotics such as isoniazid or rifampin.

Choice D is wrong because gentamicin does not causeneuromuscular blockade(paralysis of muscles).

This is more common with other aminoglycosides such as neomycin or tobramycin.

Choice E is wrong because gentamicin does not causethrombocytopenia(low platelet count).

This is more common with other drugs such as heparin or sulfonamides.

A. Urticaria B. Bronchospasm C. Anaphylaxis D. Stevens-Johnson syndrome E. Angioedema.

Correct Answer is ["A","B","C","E"]

Explanation

Cefazolin can cause serious or life-threatening allergic reactions in some patients, especially those with a history of penicillin allergy.The most common allergic reactions to cefazolin are immediate reactions, such as anaphylaxis, urticaria, bronchospasm, and angioedema.These reactions usually occur within one hour of the drug administration and may involve symptoms such as rash, itching, swelling, difficulty breathing, low blood pressure, and shock.Immediate reactions are mediated by immunoglobulin E (IgE) antibodies that bind to the drug and trigger the release of inflammatory mediators from mast cells and basophils.

Choice D is wrong because Stevens-Johnson syndrome is not a typical allergic reaction to cefazolin.

Stevens-Johnson syndrome is a rare and severe skin reaction that can be caused by various drugs, infections, or autoimmune diseases.

It involves blistering and peeling of the skin and mucous membranes, fever, malaise, and eye inflammation.

Stevens-Johnson syndrome is not mediated by IgE antibodies, but by other immune mechanisms that damage the skin cells.

Cefazolin is not known to cause Stevens-Johnson syndrome, although other cephalosporins have been reported to do so in rare cases.

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A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile. The nurse should select all that apply:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving gentamicin, an aminoglycoside antibiotic, for a severe infection. The nurse should monitor the client for which adverse effects of this drug? (Select all that apply.)

Correct Answer is ["A","B"]

Explanation

A patient is receiving cefazolin, a first-generation cephalosporin, for a surgical prophylaxis. The nurse should assess the patient for which of the following possible allergic reactions? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is caring for a client who has tuberculosis and is prescribed rifampin, an antitubercular drug. The nurse should instruct the client about which potential side effect of rifampin?

Which of the following antiviral medications inhibits neuraminidase enzyme?

A nurse is caring for a client who has a severe infection and is receiving vancomycin (Vancocin). The nurse should monitor the client for which of the following manifestations of ototoxicity?

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A nurse is educating a group of travelers who are going to a region where malaria is endemic. Which of the following antimalarial drugs should the nurse recommend for prophylaxis? (Select all that apply.).

A nurse is administering penicillin to a client who has streptococcal pharyngitis. The nurse should monitor for which adverse effect of penicillin therapy?

Which term is used to describe an agent that inhibits bacterial growth but does not kill bacteria?

A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile.
The nurse should select all that apply: