The nurse is discharging a client to home with a prescription for clarithromycin (Biaxin). The nurse knows that teaching has been effective when the client states:

A. The patient stops taking the drug when he or she begins to feel better:

This choice refers to the common habit where patients discontinue their prescribed medication once they start to feel improvement in their symptoms, even if they haven't completed the full course of treatment. This premature cessation of medication can leave some microbes alive and potentially resistant to the antibiotic, allowing them to regrow and cause a recurrence of the infection.

B. The patient switches to multiple drug therapy from single drug therapy:

This choice describes a scenario where a patient switches from a single drug therapy to multiple drug therapy. While this may be a valid treatment approach in some cases, it is not directly related to the re-population and re-establishment of microbes causing an infection.

C. The patient uses OTC drugs prophylactically:

This choice involves patients using over-the-counter (OTC) drugs preventively without consulting a healthcare professional. While OTC drugs may have their own set of issues, such as contributing to antibiotic resistance, this behavior isn't specifically linked to the re-population and re-establishment of microbes causing an infection.

D. The patient increases the drug dosage when he or she perceives that the therapeutic effect of the drug is slowing down:

This choice describes a scenario where a patient independently increases the dosage of their medication without consulting a healthcare provider. While inappropriate dosage adjustments can lead to adverse effects, it doesn't directly address the re-population and re-establishment of microbes causing an infection.

A. "Expect your urine to turn pink or red while taking this medication."

This statement is incorrect. Vancomycin does not typically cause urine discoloration. However, red man syndrome, characterized by flushing of the skin, particularly on the face and upper body, can occur with rapid infusion of vancomycin. This is not related to urine color change.

B. "Discontinue the medication once your symptoms subside."

This statement is incorrect. It's crucial for the client to complete the full course of antibiotics as prescribed, even if symptoms improve before completing the treatment course. Discontinuing the medication prematurely can lead to the development of antibiotic resistance and recurrence of the infection.

C. "Notify your provider if you experience any changes in your hearing."

This statement is correct. Vancomycin can potentially cause ototoxicity, which may manifest as changes in hearing, including ringing in the ears (tinnitus) or hearing loss. Clients should be instructed to report any such symptoms to their healthcare provider promptly.

D. "Decrease your fluid intake to 1000ml per day."

This statement is incorrect. Adequate hydration is essential, especially when taking medications like vancomycin, to help prevent kidney damage and promote drug elimination. Restricting fluid intake is not advisable unless specifically instructed by the healthcare provider for a particular medical reason.