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.
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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Related Questions
Correct Answer is D
Explanation
- Begin cardioversion to stabilize heart rhythm: Cardioversion is not the appropriate intervention for digoxin toxicity. Digoxin toxicity can cause arrhythmias, but the initial action should be to assess and manage the underlying cause, rather than immediately proceeding to cardioversion.
B) Give digoxin by another route to slow absorption: Slowing the absorption of digoxin is not the appropriate action for treating digoxin toxicity. Instead, the focus should be on managing the existing toxicity and preventing further absorption by withholding additional doses.
C) Administer potassium to stabilize the heart rate: While potassium may be indicated as part of the treatment for digoxin toxicity, particularly if hypokalemia is contributing to the toxicity, it is not the initial action. The priority is to assess the client’s acid-base and electrolyte values to identify any abnormalities contributing to the toxicity.
D) Check acid-base and electrolyte values: This is the correct action. Digoxin toxicity can be exacerbated by electrolyte imbalances, particularly hypokalemia, hypercalcemia, and hypomagnesemia. Therefore, assessing the client’s acid-base and electrolyte values is essential to identify and correct any abnormalities contributing to the toxicity. Once identified, appropriate interventions can be implemented to manage the toxicity and stabilize the client’s condition.
Correct Answer is B
Explanation
A) Calms spasm in the urinary tract: This statement is incorrect. Phenazopyridine primarily provides analgesic (pain-relieving) effects for the urinary tract but does not directly affect muscle spasms.
B) Provides an analgesic effect for irritated bladder mucosa: This is the correct response. Phenazopyridine is a urinary tract analgesic that acts locally to relieve pain, burning, and discomfort caused by irritation of the bladder mucosa. It does not treat the underlying infection but helps alleviate symptoms.
C) Eliminates urinary bacteria: This statement is incorrect. Phenazopyridine does not have antibacterial properties and does not eliminate urinary bacteria. Antibiotics are typically prescribed to treat urinary tract infections by targeting bacterial growth.
D) Use the medication after voiding after sexual intercourse: This statement is incorrect. While voiding after sexual intercourse can help reduce the risk of urinary tract infections (UTIs), phenazopyridine is not specifically indicated for this purpose. It is used primarily for symptom relief in cases of cystitis or other urinary tract irritations.
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