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. Decision to administer either a bactericidal or bacteriostatic drug:

Culture and sensitivity tests provide information about the susceptibility of the microorganism to specific antimicrobial agents. Based on this information, healthcare providers can choose between bactericidal (agents that kill bacteria) or bacteriostatic (agents that inhibit bacterial growth) drugs. For example, if the culture indicates that the microorganism is susceptible to a bactericidal drug, such as penicillin, the healthcare provider may choose to administer that type of drug.

B. Microbial susceptibility to an anti-infective:

This option accurately describes one of the primary purposes of culture and sensitivity tests. These tests determine whether the microorganism causing the infection is susceptible or resistant to specific antimicrobial agents. This information guides the selection of the most appropriate anti-infective therapy to effectively treat the infection.

C. Duration of the antibacterial drug therapy:

While culture and sensitivity tests provide valuable information about microbial susceptibility to antimicrobial agents, they do not specifically determine the duration of antibacterial drug therapy. The duration of therapy is often determined based on factors such as the type and severity of the infection, the patient's response to treatment, and clinical guidelines, rather than solely on the results of culture and sensitivity tests.

D. Decision to administer empiric therapy:

Empiric therapy involves the initiation of antimicrobial treatment based on clinical judgment and knowledge of likely pathogens before culture and sensitivity results are available. Culture and sensitivity tests help confirm the causative microorganism and guide subsequent treatment decisions, including adjustments to therapy based on the results. Therefore, while culture and sensitivity tests inform decisions regarding antimicrobial therapy, they do not directly determine whether empiric therapy should be initiated.

A. Immunocompromised patients:

Immunocompromised patients, whose immune systems are weakened or impaired, are indeed more vulnerable to drug toxicity. This vulnerability can be due to factors such as decreased ability to metabolize and eliminate drugs, increased susceptibility to infections and opportunistic pathogens, and impaired organ function, particularly in the liver and kidneys, which are involved in drug metabolism and excretion.

B. Immunocompetent patients:

Immunocompetent patients have normal immune function and are generally less vulnerable to drug toxicity compared to immunocompromised individuals. However, susceptibility to drug toxicity can still vary depending on factors such as age, underlying health conditions, renal and hepatic function, and concurrent use of other medications.

C. Infants and elderly patients:

Infants and elderly patients are more vulnerable to drug toxicity due to factors such as immature or declining organ function, altered drug metabolism and elimination, and differences in body composition. In infants, organ systems are still developing, while in elderly patients, age-related changes can affect drug pharmacokinetics and increase the risk of adverse reactions.

D. Patients who have allergic reactions:

Patients who have allergic reactions may experience adverse drug reactions if they are exposed to the offending medication again. However, this does not necessarily make them more vulnerable to drug toxicity in general. Allergic reactions are specific immune responses and differ from drug toxicity, which can occur due to various mechanisms unrelated to allergies.