The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)

Using an infusion pump for IV therapy

Discontinuing the drug immediately if the patient develops tingling and numbness in the extremities

If adverse effects occur, reducing the IV rate gradually until they subside

Administering the medication by rapid IV infusion

Monitoring the IV site for signs of phlebitis and infiltration

Answer and Explanation

Correct Answer : A,B,E

Choice A reason: Using an infusion pump ensures precise delivery of amphotericin B, which requires controlled infusion rates to minimize toxicity. Amphotericin B’s nephrotoxic and infusion-related reactions (e.g., fever, chills) necessitate accurate dosing, as rapid administration increases adverse effects, making pumps essential for safe administration.

Choice B reason: Discontinuing amphotericin B for tingling and numbness is appropriate, as these may indicate neurotoxicity or severe infusion reactions. Stopping the infusion prevents further exposure, allowing assessment of potential electrolyte imbalances or neurological damage, ensuring patient safety during this high-risk antifungal therapy.

Choice C reason: Reducing the IV rate for adverse effects like fever or chills may be appropriate, but tingling and numbness require immediate discontinuation, as they suggest serious toxicity. Rate reduction is insufficient for neurological symptoms, which demand urgent evaluation to prevent irreversible harm, making this action less prioritized.

Choice D reason: Rapid IV infusion of amphotericin B is inappropriate, as it increases the risk of nephrotoxicity and infusion reactions. Slow, controlled infusion over several hours minimizes toxicity, as amphotericin B’s binding to ergosterol causes systemic effects that worsen with faster administration, making this incorrect.

Choice E reason: Monitoring the IV site for phlebitis and infiltration is essential, as amphotericin B is irritating to veins. Phlebitis or extravasation can cause tissue damage, and regular site checks ensure proper drug delivery and prevent complications, supporting safe administration of this potent antifungal.

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Correct Answer is B

Explanation

Choice A reason: Orange-tinged urine is an expected effect of rifampin, not a therapeutic response. It results from the drug’s red-orange metabolite excreted in urine, not an indicator of tuberculosis resolution. Clinical improvement, like reduced symptoms and negative cultures, better reflects the effectiveness of antitubercular therapy.

Choice B reason: A therapeutic response to antitubercular therapy is indicated by decreased symptoms (e.g., cough, fever), improved chest radiographs (reduced infiltrates), and negative sputum cultures, showing reduced Mycobacterium tuberculosis burden. These objective measures confirm the drugs, like isoniazid and rifampin, are effectively killing the bacteria and resolving the infection.

Choice C reason: Increased tolerance to antitubercular therapy or fewer adverse effects does not indicate a therapeutic response. Tolerance reflects patient adaptation to side effects, not bacterial clearance. Objective measures like symptom reduction and negative cultures are needed to confirm the therapy’s effectiveness against tuberculosis.

Choice D reason: Negative PPD results are not used to monitor active tuberculosis treatment. PPD tests detect latent tuberculosis or prior exposure, not active disease. Therapeutic response is assessed through symptom improvement, chest imaging, and sputum cultures, which directly indicate the reduction of active Mycobacterium tuberculosis infection.

A. Your prescriber hopes that at least one of these drugs will work to fight the tuberculosis. B. Using more than one drug can help to reduce side effects. C. Using multiple drugs enhances the effect of each drug. D. Taking multiple drugs is recommended because more drugs are becoming resistant to TB drug therapy. E. The correct answer is: c) Using multiple drugs enhances the effect of each drug.

Correct Answer is C

Explanation

Choice A reason: The purpose of multiple drugs in tuberculosis treatment is not to hope one works but to ensure comprehensive bacterial eradication. Combination therapy targets different aspects of Mycobacterium tuberculosis, preventing resistance and ensuring efficacy, as single-drug therapy is ineffective and promotes resistant strains.

Choice B reason: Multiple drugs do not primarily reduce side effects; they increase the likelihood of adverse effects due to cumulative toxicity (e.g., hepatotoxicity from isoniazid and rifampin). The rationale for combination therapy is to enhance efficacy and prevent resistance, not to mitigate side effects, making this incorrect.

Choice C reason: Combination therapy (e.g., isoniazid, rifampin, ethambutol, pyrazinamide) enhances efficacy by targeting different bacterial populations and metabolic states of Mycobacterium tuberculosis. This synergistic approach ensures rapid bacterial killing, prevents resistance, and shortens treatment duration, making it the standard for effective tuberculosis management.

Choice D reason: The use of multiple drugs is not because drugs are becoming resistant but to prevent resistance development. Combination therapy overwhelms Mycobacterium tuberculosis with multiple mechanisms, reducing the chance of resistant mutants surviving. Resistance occurs with inadequate or monotherapy, not as a rationale for combination therapy.

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The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

Explanation

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