The nurse is caring for a client with a fungal infection and prescribed fluconazole (Diflucan). Which of the following side effects should the nurse caution the client regarding?

Increase in the client's liver panel.

Increase in the client's creatinine clearance.

Change of color to the clients' secretions.

Red Man syndrome

Answer and Explanation

The Correct Answer is A

A) Increase in the client's liver panel:
Fluconazole (Diflucan) is an antifungal medication that is metabolized in the liver, and one of the potential side effects of this drug is liver toxicity. This can manifest as an increase in liver enzymes (such as AST, ALT, or alkaline phosphatase) seen in the liver panel. It is important for the nurse to monitor the client’s liver function, especially if the patient has pre-existing liver conditions. If there are signs of liver toxicity, such as jaundice, abdominal pain, or elevated liver enzymes, the healthcare provider should be notified and the medication may need to be adjusted or discontinued.

B) Increase in the client's creatinine clearance:
Fluconazole is primarily eliminated through the kidneys, but it does not typically cause an increase in creatinine clearance. In fact, in patients with renal impairment, fluconazole can lead to an increase in serum creatinine levels due to reduced renal clearance of the drug. Therefore, a decrease (rather than an increase) in creatinine clearance is a more common concern, and renal function should be monitored during treatment.

C) Change of color to the client's secretions:
Fluconazole is not known to cause a change in the color of secretions (such as urine, saliva, or sweat). This side effect is more commonly associated with certain medications like rifampin (which can turn urine or sweat orange). However, fluconazole’s side effects are generally related to liver and renal function, as well as gastrointestinal disturbances, not to changes in secretions.

D) Red Man syndrome:
Red Man syndrome is a reaction typically associated with vancomycin, an antibiotic used for Gram-positive infections, especially when administered too rapidly via IV. It is characterized by flushing, rash, and hypotension, and is not a side effect of fluconazole. Fluconazole does not cause this type of infusion-related reaction, so this is not a concern with fluconazole therapy.

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Correct Answer is ["A","C","F"]

Explanation

A) This medication may cause discoloration of the teeth:
Doxycycline is a tetracycline-class antibiotic, and like other drugs in this group, it can bind to calcium in developing teeth, leading to permanent discoloration if taken during childhood or by pregnant or breastfeeding women whose fetuses or infants are exposed to the drug. In adults, it can still cause temporary staining, especially with prolonged use. Patients should be informed about this potential side effect to prevent concern and encourage good oral hygiene.

B) This medication should not be taken if you are lactating:
Doxycycline is generally considered compatible with breastfeeding, although it should be used with caution. While doxycycline does pass into breast milk, the risk to an infant is minimal, particularly for short-term use. However, the safety profile may vary depending on the infant's age and health, and a healthcare provider should evaluate the risks and benefits in each case.

C) This medication should not be taken with antacids:
Antacids containing calcium, magnesium, or aluminum can interfere with the absorption of doxycycline. These minerals bind to the antibiotic in the gastrointestinal tract, decreasing its effectiveness. It is recommended to space the administration of doxycycline and antacids by at least 2 hours to ensure adequate absorption of the medication. This is a key consideration in managing patients taking doxycycline.

D) This medication can cause hyperglycemia:
Doxycycline is not typically associated with hyperglycemia. Hyperglycemia is not a common or expected side effect of this medication. Doxycycline's side effects more commonly involve gastrointestinal distress, photosensitivity, and potential effects on the liver or kidneys. Hyperglycemia would be more likely in a diabetic patient on steroids or other specific medications, not generally with doxycycline.

E) This medication should not be administered to anyone under the age of 20 years old:
Doxycycline is contraindicated in children under 8 years old due to the risk of tooth discoloration and impaired bone development, not generally in those under 20 years of age. While it may be used with caution in adolescents for specific infections, the drug is not recommended for younger children. However, there is no blanket restriction for those under 20, especially if the benefits outweigh the risks.

F) This medication may cause photosensitivity:
Doxycycline can increase the skin’s sensitivity to sunlight, resulting in an increased risk of sunburn or skin rash. This is a well-known side effect of tetracycline antibiotics, and patients taking doxycycline should be advised to avoid prolonged sun exposure, wear sunscreen, and protective clothing to reduce the risk of photosensitivity reactions.

A. Tendon Rupture B. Increase risk of lymphomas C. Thromboembolic events D. Photosensitivity

Correct Answer is C

Explanation

A. Tendon Rupture:
Tendon rupture is not a commonly associated side effect of estrogen blockers. While some medications, particularly corticosteroids or fluoroquinolones, may carry a risk of tendon issues, estrogen blockers like tamoxifen or aromatase inhibitors primarily influence hormone-driven cancer cell growth and do not have a direct link to tendon rupture. Therefore, cautioning the client regarding tendon rupture is not a priority when administering estrogen blockers.

B. Increase risk of lymphomas:
Estrogen blockers are primarily associated with changes in estrogen receptor activity, which can affect various bodily systems. However, the increased risk of lymphoma is not a major concern associated with these drugs. Side effects related to estrogen blockers usually involve blood clots, hot flashes, and menstrual irregularities, not an increased incidence of lymphomas. This makes cautioning clients about lymphoma less relevant.

C. Thromboembolic events:
Thromboembolic events, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke, are a well-known and serious side effect of estrogen blockers like tamoxifen. These drugs can increase the risk of clotting due to their effects on the coagulation system. Estrogen has pro-thrombotic effects, and estrogen blockers can exacerbate this, making it essential to caution clients about signs and symptoms of clots and to monitor for such events during therapy.

D. Photosensitivity:
Photosensitivity is not a significant concern with estrogen blockers. Although some medications can cause increased sensitivity to sunlight, this is not a major side effect for most estrogen blockers. The more pressing concerns typically involve thromboembolic risks, as well as potential effects on mood, bone density, and menstrual function. Thus, while sun protection is important in general, photosensitivity is not a primary issue with estrogen blockers in the treatment of breast cancer.

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The nurse is caring for a client with a fungal infection and prescribed fluconazole (Diflucan). Which of the following side effects should the nurse caution the client regarding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","C","F"]

Explanation

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Correct Answer is C

Explanation

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