A patient has been prescribed azithromycin, a macrolide antibiotic, for a respiratory infection.
The nurse should instruct the patient to report which of the following signs or symptoms of a potential adverse effect?

Diarrhea

Headache

Chest pain

Nausea.

Answer and Explanation

The Correct Answer is C

Azithromycin is a macrolide antibiotic that can cause a rare but serious side effect called QT prolongation, which affects the electrical activity of the heart and can lead to irregular heartbeats, chest pain, and sudden cardiac death. The patient should report any signs of chest pain or palpitations to the doctor immediately.

Choice A is wrong because diarrhea is a common side effect of azithromycin that usually does not require medical attention unless it is severe or bloody.

Choice B is wrong because headache is also a common side effect of azithromycin that usually does not require medical attention unless it is severe or persistent.

Choice D is wrong because nausea is another common side effect of azithromycin that usually does not require medical attention unless it is severe or accompanied by vomiting.

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

Explanation

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.

A. Take the drug on an empty stomach. B. Avoid dairy products while taking this drug. C. Use sunscreen or avoid exposure to sunlight. D. Drink plenty of fluids while taking this drug. E. Report any vaginal itching or discharge.

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

Explanation

The nurse should include these instructions in the teaching because:

• Tetracycline should be taken on an empty stomach to avoid interference with absorption.

• Dairy products should be avoided while taking this drug because they contain calcium, which can form insoluble complexes with tetracycline and reduce its effectiveness.

• Sunscreen or sun avoidance should be used while taking this drug because it can cause photosensitivity, which increases the risk of sunburn and skin damage.

• Plenty of fluids should be drunk while taking this drug because it can cause nephrotoxicity, which is damage to the kidneys.

Choice E is wrong because vaginal itching or discharge is not a common side effect of tetracycline.It may indicate a superinfection, which is a secondary infection caused by the disruption of normal flora by antibiotics.

This should be reported to the health care provider as soon as possible.

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A patient has been prescribed azithromycin, a macrolide antibiotic, for a respiratory infection. The nurse should instruct the patient to report which of the following signs or symptoms of a potential adverse effect?

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Explanation

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A patient has been prescribed azithromycin, a macrolide antibiotic, for a respiratory infection.
The nurse should instruct the patient to report which of the following signs or symptoms of a potential adverse effect?