Which statements made about theophylline by a patient with asthma would alert the nurse that further intervention is warranted? (Select all that apply)
I should avoid smoking and being around smoke while I am taking the drug.
I should take an extra dose during an asthma attack.
If I accidentally miss a dose, I can double up on my next dose.
I should avoid caffeine as much as possible while receiving theophylline.
I will routinely follow up with my health care provider to have my drug levels determined.
Correct Answer : B,C
Choice A reason: Avoiding smoking is appropriate, as it can exacerbate asthma and reduce theophylline efficacy by inducing hepatic CYP450 enzymes, increasing drug clearance. This statement reflects correct understanding, as smoke exposure worsens airway inflammation, and theophylline’s narrow therapeutic index requires stable metabolism.
Choice B reason: Taking an extra dose of theophylline during an asthma attack is dangerous. Theophylline, a methylxanthine, is used for maintenance, not acute relief, due to its slow onset and narrow therapeutic index. Extra doses risk toxicity (e.g., seizures, arrhythmias), requiring immediate nurse intervention to correct this misconception.
Choice C reason: Doubling a missed theophylline dose is unsafe due to its narrow therapeutic index. Theophylline’s metabolism varies, and doubling doses can lead to toxic levels, causing nausea, tachycardia, or seizures. The nurse must intervene to educate the patient on adhering to the prescribed schedule without adjustments.
Choice D reason: Avoiding caffeine is correct, as it is a methylxanthine like theophylline, potentially increasing plasma levels and toxicity by competing for metabolism. Caffeine can exacerbate theophylline’s side effects like nervousness or tachycardia, so this statement reflects appropriate patient understanding and does not require intervention.
Choice E reason: Routine follow-up to monitor theophylline levels is appropriate due to its narrow therapeutic index (10-20 mcg/mL). Regular blood tests ensure therapeutic efficacy and prevent toxicity, as metabolism varies. This statement indicates correct understanding, supporting safe use without needing nurse intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Definitive therapy targets a confirmed infection with antibiotics chosen based on culture results. Prescribing antibiotics before a dental procedure for a heart condition aims to prevent infection, not treat an existing one, making this incorrect for endocarditis prophylaxis.
Choice B reason: Empiric therapy involves antibiotics for suspected infections without confirmed pathogens. Antibiotics before dental procedures in heart patients prevent endocarditis, not treat suspected infections. This is a preventive measure based on risk, not empiric treatment, making this incorrect.
Choice C reason: Supportive therapy addresses symptoms or supports other treatments, not infection prevention. Antibiotics before dental procedures in patients with heart conditions (e.g., valvular disease) prevent bacterial endocarditis, a specific prophylactic measure, not supportive care, making this an incorrect classification.
Choice D reason: Prophylactic antibiotic therapy prevents infections in high-risk patients, such as those with heart conditions (e.g., mitral valve prolapse) before dental procedures. It reduces the risk of bacterial endocarditis from transient bacteremia, aligning with guidelines for prophylaxis in susceptible individuals, making this correct.
Correct Answer is B
Explanation
Choice A reason: Carbapenems, like imipenem, are broad-spectrum antibiotics reserved for severe, multidrug-resistant infections. They are not first-line for uncomplicated urinary tract infections due to their potency and risk of promoting resistance. Sulfonamides are more commonly used for UTIs due to their efficacy and specificity.
Choice B reason: Sulfonamides, like trimethoprim-sulfamethoxazole, are especially useful for urinary tract infections. They inhibit bacterial folate synthesis, targeting pathogens like Escherichia coli, a common UTI cause. Their concentration in urine enhances efficacy, making them a first-line choice for uncomplicated UTIs in susceptible organisms.
Choice C reason: Tetracyclines, like doxycycline, are not typically used for urinary tract infections. They are effective for other infections, like chlamydia, but their spectrum and renal clearance make them less ideal for common UTI pathogens like E. coli compared to sulfonamides or nitrofurantoin.
Choice D reason: Macrolides, like erythromycin, are used for respiratory or soft tissue infections, not primarily for urinary tract infections. They have limited activity against common UTI pathogens like E. coli and do not concentrate effectively in urine, making sulfonamides a more appropriate choice.
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