A) Primaxin B) Gemifloxacin C) Demeclocycline D) Cefuroxime 11/13/17, 4T51 PM Page 74 of 81
Ans: A Feedback: The group consists of three drugs: imipenem-cilastatin (Primaxin), meropenem (Merrem), and ertapenem (Invanz). Gemifloxacin is a Fluoroquinolones, Cefuroxime is a second-generation cephalosporin, and demeclocycline is a tetracycline. 27. An intensive care unit nurse is caring for a patient taking kanamycin. What is the nurse's priority action? A) Giving the drug for no longer than 7 days B) Assessing liver function daily C) Contacting the ordering physician D) Monitoring renal function daily Ans: D Feedback: The potential for nephrotoxicity and ototoxicity with amikacin is very high, so the drug is used only as long as absolutely necessary and should not be administered for longer than 7 to 10 days because of its potentially toxic adverse effects, which include renal damage, bone marrow depression, and gastrointestinal (GI) complications. The nurse cannot stop administering the drug after 7 days if the doctor orders it to be given longer but the nurse could question the order and promote change to another antibiotic if necessary. Monitoring renal function is the priority action when this drug is administered and the provider should be notified if signs of renal failure occur. Liver function is not usually impacted by this drug, although a patient with preexisting liver alterations may require a change in dosage 11/13/17, 4T51 PM Page 75 of 81
although a patient with preexisting liver alterations may require a change in dosage to prevent toxicity. There is no indication of a need to contact the health care provider. 28. The clinic nurse is providing health teaching to a patient who has been prescribed doxycycline (Doxycin). What is a priority teaching point for this patient? A) Stay out of the sun. B) Avoid sexual activity. C) Take an antacid with the drug if nausea occurs. D) Chew the tablets completely before swallowing. Ans: A Feedback: Encourage the patient to apply sunscreen and wear protective clothing if sun exposure cannot be avoided to protect exposed skin from rashes and sunburn associated with photosensitivity reactions. If the patient is a woman the nurse may advise the patient to use barrier methods of contraceptives (if she is taking oral contraceptives) due to the drug–drug interaction but the patient would not be told to avoid sexual activity. Antacid therapy and chewing the tablets would be inaccurate information. 29. The mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her child needs an antibiotic. What is the priority rationale the nurse should give the mother? A) It is better absorbed. B) It is less costly. C) It has a less frequent dosing schedule. D) It tastes better in oral form.
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