A nurse is teaching a patient who has been prescribed metronidazole, a nitroimidazole antibiotic, for a bacterial infection.
The nurse instructs the patient to avoid consuming what substance while taking this medication?

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.

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.