During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?

Nothing; these are expected side effects of this medication.

Reduce the infusion rate gradually until the adverse effects subside.

Discontinue the infusion immediately.

Administer the medication by rapid IV infusion to reduce these effects.

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is B

Explanation

Choice A reason: Headache and nervousness are not significant adverse effects of antitubercular drugs like isoniazid or rifampin. These symptoms are nonspecific and less concerning than neurotoxicity. Antitubercular drugs primarily affect the liver, nerves, or blood, making neurological symptoms like numbness more critical to report.

Choice B reason: Numbness and tingling of extremities indicate peripheral neuropathy, a serious adverse effect of isoniazid, which depletes pyridoxine (vitamin B6), impairing nerve function. This requires immediate reporting to adjust therapy or add pyridoxine supplementation, preventing irreversible nerve damage while continuing effective tuberculosis treatment.

Choice C reason: Reddish-orange urine and stool are expected effects of rifampin, which is metabolized to a red-orange compound excreted in bodily fluids. This is harmless and does not require reporting unless accompanied by other symptoms like jaundice, which could indicate hepatotoxicity, a more serious concern.

Choice D reason: Gastrointestinal upset is common with antitubercular drugs like rifampin or pyrazinamide but is not typically severe enough to warrant immediate reporting unless persistent or accompanied by signs of hepatotoxicity. Numbness is a more concerning neurological effect, requiring prompt prescriber notification to prevent complications.

A. It is used for the prevention of bronchospasms. B. It needs to be used with a spacer for best results. C. Patients need to avoid drinking water for 1 hour after taking this drug. D. It is indicated for the treatment of acute therapy.

Correct Answer is A

Explanation

Choice A reason: Fluticasone/salmeterol is a combination of an inhaled corticosteroid and a long-acting beta-2 agonist used for maintenance therapy to prevent bronchospasms in asthma or COPD. Fluticasone reduces inflammation, while salmeterol provides sustained bronchodilation, making it effective for long-term control, not acute relief.

Choice B reason: Using a spacer with fluticasone/salmeterol is not mandatory, though it may improve drug delivery in some patients. Spacers enhance lung deposition for metered-dose inhalers, but this combination is often delivered via dry powder inhalers, which do not require spacers, making this statement inaccurate.

Choice C reason: Avoiding water for 1 hour after using fluticasone/salmeterol is unnecessary. Patients should rinse their mouth after inhalation to prevent oral thrush, but water restriction is not required. The drug’s local action in the lungs is unaffected by oral hydration, making this instruction incorrect.

Choice D reason: Fluticasone/salmeterol is not indicated for acute therapy. Its slow onset (salmeterol takes 20-30 minutes) makes it unsuitable for acute bronchospasm. It is used for maintenance to prevent symptoms, while short-acting beta-agonists like albuterol are used for acute asthma or COPD exacerbations.

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During an intravenous (IV) infusion of amphotericin B, a patient develops tingling and numbness in his toes and fingers. What will the nurse do first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. Which potential adverse effect of antitubercular drug therapy should the patient report to the prescriber?

Correct Answer is B

Explanation

The nurse is providing instructions about the fluticasone propionate and salmeterol combination inhaler. Which statement about this inhaler is accurate?

Correct Answer is A

Explanation

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