The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

Protect the skin from sunlight while taking the drug.

Take with orange juice to enhance GI absorption.

Return to the clinic weekly to obtain serum drug levels.

Take with milk or antacids to prevent gastrointestinal (GI) irritation.

Answer and Explanation

The Correct Answer is A

Choice A reason: Tetracycline HCl can cause photosensitivity, which increases the risk of sunburn and skin damage. The client should avoid direct sunlight and use sunscreen and protective clothing while taking the drug.

Choice B reason: Orange juice is acidic and can decrease the absorption of tetracycline HCl. The client should take the drug with water and avoid acidic foods and beverages.

Choice C reason: Serum drug levels are not routinely monitored for tetracycline HCl. The client should follow the prescribed dosage and duration of the therapy.

Choice D reason: Milk and antacids can interfere with the absorption of tetracycline HCl. The client should take the drug at least 1 hour before or 2 hours after meals and avoid dairy products and antacids.

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Correct Answer is D

Explanation

Choice A reason: Spinach and other green vegetables are rich in vitamin K, which is essential for blood clotting. However, dabigatran is not affected by vitamin K intake, unlike warfarin, another anticoagulant drug. Therefore, there is no need to eliminate these foods from the diet.

Choice B reason: Dabigatran does not require routine laboratory monitoring of bleeding parameters, such as prothrombin time (PT) or international normalized ratio (INR), unlike warfarin. Therefore, the client does not need to continue obtaining scheduled laboratory bleeding tests.

Choice C reason: Dabigatran is a direct thrombin inhibitor that prevents the formation of fibrin, the main component of blood clots. In case of a major bleeding event, the antidote for dabigatran is idarucizumab, a monoclonal antibody that binds to dabigatran and reverses its effect. However, this antidote is not readily available in most settings and should only be administered by a health care provider. Therefore, the client should not keep an antidote available at home.

Choice D reason: NSAIDs, such as ibuprofen or naproxen, can increase the risk of bleeding by inhibiting platelet aggregation and damaging the gastric mucosa. Therefore, the client should avoid using these drugs while taking dabigatran. The client should consult with the prescriber before taking any other medications, including over-the-counter or herbal products.

A. Lorazepam. B. Digoxin. C. Sucralfate. D. Vancomycin.

Correct Answer is D

Explanation

Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.

Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.

Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.

Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.

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The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

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