The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Hold the dose and notify the pharmacy to stop dispensing the next premixed doses.

Hold the dose and notify the healthcare provider of the changes in the laboratory studies.

Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests.

Begin the infusion and submit a drug reaction report to the nursing supervisor.

Answer and Explanation

The Correct Answer is B

A) Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: This action may prevent further administration of fluconazole, but it does not address the underlying concern of rising liver enzyme levels. Holding the dose and notifying the healthcare provider directly would be more appropriate.

B) Hold the dose and notify the healthcare provider of the changes in the laboratory studies: This is the correct response. RisIng liver enzyme levels, indIcated by an increasing trend in aspartate aminotransferase (AST), suggest potential liver dysfunction or damage, which can be a serious adverse effect of fluconazole. The nurse should hold the dose and promptly inform the healthcare provider for further evaluation and management.

C) Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests: Initiating the infusion without addressing the rising liver enzyme levels could potentially worsen liver function. It is essential to hold the dose and inform the healthcare provider before proceeding with further administration.

D) Begin the infusion and submit a drug reaction report to the nursing supervisor: While it's im’ortant to document adverse reactions and submit reports as appropriate, the priority in this situation is to hold the dose and notify the healthcare provider to address the rising liver enzyme levels.

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Correct Answer is B

Explanation

A) Increased frequency of lacrimation is not typically associated with miotic therapy. Miotics work by constricting the pupil and increasing outflow of aqueous humor to reduce intraocular pressure, but they do not directly affect lacrimation (tear production). Therefore, this option is not the etiology for the “Risk for injury” nursing problem.

B) Decreased night vision is a common side effect of miotic therapy. Miotics constrict the pupil, which can reduce the amount of light entering the eye, leading to impaired night vision or difficulty seeing in low-light conditions. This impaired vision increases the risk of injury, particularly in situations with reduced lighting.

C) Increased sensitivity to light (photophobia) is not typically associated with miotic therapy. Miotics constrict the pupil, which may actually reduce sensitivity to light by decreasing the amount of light entering the eye. Therefore, increased sensitivity to light is not the etiology for the “Risk for injury” nursing problem in this case.

D) Diminished color perception is not a common side effect of miotic therapy. Miotics primarily affect pupil constriction and intraocular pressure but do not typically alter color perception. Therefore, diminished color perception is not the etiology for the “Risk for injury” nursing problem.

A. Acetaminophen. B. Prednisone. C. Captopril. D. Omeprazole.

Correct Answer is A

Explanation

A) Acetaminophen is metabolized by the liver, and jaundice can indicate liver dysfunction or impairment. Therefore, the nurse should notify the healthcare provider about the scheduled acetaminophen to ensure appropriate monitoring of liver function and to consider alternative pain management options.

B) Prednisone is a corticosteroid that primarily affects the immune system and inflammation and is not directly metabolized by the liver. While prednisone can have side effects related to liver function, such as hepatotoxicity, jaundice is not a common manifestation.

C) Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While it can affect renal function, jaundice is not a typical side effect of captopril.

D) Omeprazole is a proton pump inhibitor (PPI) used to reduce gastric acid production and treat conditions such as gastroesophageal reflux disease (GERD). It is primarily metabolized in the liver, but jaundice is not a common side effect associated with its use.

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The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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