A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left
... [Show More] eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology.
How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
Response Feedback:
Ciprofloxacin is contraindicated in patients who are pregnant or lactating. Alternative routes and dosages do not mitigate the risks during pregnancy.
A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
Response Feedback:
Rifampin can discolor body fluids red–orange. The patient should be informed that this is an expected adverse effect and is harmless.
However, wearers of soft contact lenses should be cautioned that the lenses may be permanently discolored and that hard contacts or regular glasses should be used during the therapy. Although rifampin is often well tolerated, it may cause GI disturbances such as nausea and vomiting, anorexia, flatulence, cramps, and diarrhea. Cardiac arrhythmias, seizures, and facial flushing are not typically associated with the use of this drug.
A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment?
Response Feedback:
Amphotericin B is associated with numerous adverse effects that influence a variety of body systems. Paramount among these, however, is the drug's potential for nephrotoxicity and electrolyte disturbances. Erythropoiesis and coagulation may also be affected, but these adverse effects are normally less profound. Changes in C- reactive protein levels are not associated with the use of amphotericin B.
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
Response Feedback:
The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity. [Show Less]