A patient has a urinary tract infection. The nurse knows which class of drugs is especially useful for such infections?

Choice A reason: Collecting urine culture before blood culture and antibiotics is incorrect. Blood cultures are prioritized to detect systemic infection, as fever suggests possible bacteremia. Administering antibiotics before cultures may sterilize samples, reducing diagnostic accuracy, making this sequence inappropriate for identifying the infection source.

Choice B reason: Administering antibiotics before cultures is incorrect, as it may reduce culture sensitivity by killing bacteria, leading to false-negative results. Blood and urine cultures must be obtained first to identify the causative organism and its antibiotic susceptibility, ensuring accurate treatment for suspected urinary tract infection.

Choice C reason: Obtaining blood and urine cultures before antibiotics is correct. Cultures identify the causative organism and guide targeted therapy, especially with fever and cloudy urine suggesting a urinary tract infection. Administering antibiotics after cultures ensures diagnostic accuracy, as antibiotics may sterilize samples, reducing culture yield.

Choice D reason: Collecting blood culture before antibiotics and urine culture after is suboptimal. Both cultures should be obtained before antibiotics to maximize diagnostic yield, as fever and urinary symptoms suggest possible systemic or urinary infection. Delaying urine culture risks missing the primary infection source.

Choice A reason: Tingling and numbness are not expected side effects of amphotericin B. Common side effects include fever, chills, and nephrotoxicity. Neurological symptoms like paresthesia may indicate serious toxicity or infusion reactions, requiring immediate action, not dismissal, to prevent potential nerve damage or systemic complications.

Choice B reason: Reducing the infusion rate may help with infusion-related reactions like fever but is not the first action for tingling and numbness, which suggest neurotoxicity or electrolyte imbalances (e.g., hypomagnesemia). Stopping the infusion is prioritized to assess and prevent further harm, followed by physician consultation.

Choice C reason: Discontinuing amphotericin B infusion immediately is critical for tingling and numbness, as these may indicate neurotoxicity or severe infusion reactions. Amphotericin B’s binding to ergosterol can cause systemic toxicity, and stopping the infusion prevents further exposure, allowing assessment of symptoms and potential electrolyte or neurological issues.

Choice D reason: Rapid IV infusion of amphotericin B is contraindicated, as it increases toxicity, including nephrotoxicity and infusion reactions. Tingling and numbness require stopping the infusion, not speeding it up, to avoid exacerbating potential neurotoxic or systemic effects, ensuring patient safety during antifungal therapy.