A client has been prescribed an antibiotic and overhears the prescriber talking about acquired resistance. The client asks the nurse what this means. What is the nurse's best statement regarding acquired resistance?

A. Chocolate:

Chocolate contains tyramine, a substance that can interact with certain medications like monoamine oxidase inhibitors (MAOIs) to increase blood pressure. While isoniazid itself does not directly interact with tyramine, it is often recommended to avoid tyramine-rich foods to prevent potential interactions with other medications or to minimize potential risks. Therefore, clients taking isoniazid are advised to avoid consuming chocolate to reduce the risk of adverse effects.

B. Aged cheese:

Aged cheeses, such as cheddar, Swiss, and blue cheeses, are high in tyramine. Tyramine levels increase as cheeses age, and consuming aged cheeses can lead to tyramine buildup in the body, potentially causing hypertensive crisis when combined with certain medications like MAOIs. While isoniazid is not an MAOI, the cautionary advice to avoid tyramine-rich foods is often extended to individuals taking isoniazid to minimize potential risks.

C. Bananas:

Bananas contain tyramine, although in lower amounts compared to some other foods. However, it is still advisable for individuals taking isoniazid to avoid consuming bananas and other tyramine-rich foods to reduce the risk of potential interactions or adverse effects.

D. Red meat:

Red meat is not typically high in tyramine compared to other foods like aged cheeses, certain processed meats, and fermented foods. While some sources suggest limiting consumption of aged or fermented meats, fresh red meat is generally considered safe to consume while taking isoniazid.

E. White wine:

While red wine is more commonly associated with tyramine content, white wine can also contain tyramine and other biogenic amines. Like other tyramine-rich foods, white wine consumption should be limited or avoided by individuals taking isoniazid to minimize the risk of tyramine-related interactions or adverse effects.

A. By assessing the temperature every 4 hours:

Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.

B. By repeating a culture and sensitivity test on day 3:

Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.

C. By obtaining drug peak and trough levels:

This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.

D. By assessing for breathlessness:

Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.