A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

Keep medication refrigerated.

Drink a liter of water daily.

Take one hour after eating.

Avoid the use of alcohol.

Answer and Explanation

The Correct Answer is D

A) Keep medication refrigerated:
Metronidazole tablets do not typically require refrigeration. Storing the medication at room temperature is usually sufficient. Refrigeration may not be necessary and could potentially lead to confusion or unnecessary inconvenience for the client.

B) Drink a liter of water daily:
While maintaining hydration is generally important for overall health, there's no specific requirement to drink a liter of water daily solely because of metronidazole therapy. However, encouraging adequate fluid intake is beneficial to prevent dehydration, especially if diarrhea is present due to Clostridium difficile infection.

C) Take one hour after eating:
Metronidazole can be taken with or without food. It's generally well tolerated with food to reduce gastrointestinal side effects such as nausea. However, taking it with food or on an empty stomach does not significantly affect its effectiveness.

D) Avoid the use of alcohol:
This is the correct answer. Consuming alcohol while taking metronidazole can lead to a disulfiram-like reaction, characterized by symptoms such as flushing, headache, nausea, vomiting, and abdominal cramps. This reaction occurs because metronidazole inhibits the breakdown of acetaldehyde, leading to its accumulation in the body when alcohol is consumed. Therefore, it's crucial to advise clients to abstain from alcohol during metronidazole therapy and for at least 48 hours after completing the course of treatment.

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Correct Answer is A

Explanation

A) Advise the client to move slowly and cautiously when rising and walking: This intervention is essential because baclofen, a muscle relaxant, can cause dizziness, drowsiness, and muscle weakness as side effects. Instructing the client to move slowly and cautiously can help prevent falls and injuries due to these potential side effects.
B) Monitor intake and output every 8 hours: Monitoring intake and output is not directly related to the administration of baclofen. While it is essential to monitor fluid balance in some situations, it is not specifically indicated in this case.
C) Ensure the client knows to stop baclofen before using other antispasmodics: While it is important to avoid concurrent use of multiple antispasmodic medications without proper medical supervision, stopping baclofen abruptly without medical guidance can lead to withdrawal symptoms. Therefore, this intervention is not appropriate without further clarification from the healthcare provider.
D) Evaluate muscle strength every 4 hours: While monitoring muscle strength is essential for clients receiving muscle relaxants, such as baclofen, evaluating it every 4 hours may not be necessary unless there are specific concerns or as directed by the healthcare provider. Monitoring for signs of muscle weakness or adverse effects should be ongoing but may not require such frequent assessments.

A. Undergo annual eye examinations. B. Have a chest x-ray prior to your first dose. C. Avoid crowds and people who are sick. D. Obtain routine vaccinations as scheduled.

Correct Answer is C

Explanation

A) Undergo annual eye examinations:
While methotrexate and adalimumab can both have potential ocular side effects, such as blurred vision or eye pain, the need for annual eye examinations is more commonly associated with methotrexate therapy. Methotrexate can cause ocular toxicity, including retinopathy and optic neuropathy, which necessitates regular monitoring by an ophthalmologist. However, adalimumab is not typically associated with annual eye examinations, so this instruction is not directly relevant to the addition of adalimumab to the client’s regimen.

B) Have a chest x-ray prior to your first dose:
A chest x-ray is not routinely required before initiating adalimumab therapy. While screening for tuberculosis (TB) may be necessary in clients starting adalimumab due to its immunosuppressive effects, a chest x-ray is not always indicated for this purpose. Instead, TB screening usually involves a thorough history, physical examination, and possibly tuberculin skin testing or interferon-gamma release assays. Therefore, this instruction is not specifically related to the addition of adalimumab to the client’s treatment regimen.

C) Avoid crowds and people who are sick:
Adalimumab is a biologic disease-modifying antirheumatic drug (DMARD) that suppresses the immune system’s inflammatory response by targeting tumor necrosis factor-alpha (TNF-alpha). As a result, clients taking adalimumab are at increased risk of infections, including bacterial, viral, and fungal infections. Therefore, instructing the client to avoid crowds and individuals who are sick helps reduce the risk of exposure to infectious pathogens and minimize the likelihood of developing infections while on adalimumab therapy.

D) Obtain routine vaccinations as scheduled:
While maintaining up-to-date vaccinations is important for overall health and immunity, clients receiving biologic DMARDs like adalimumab may have a reduced response to vaccines due to immunosuppression. Therefore, it is generally recommended to administer necessary vaccinations before starting adalimumab therapy whenever possible. However, the decision to administer vaccines should be individualized, and certain live vaccines may be contraindicated while receiving adalimumab. Nonetheless, this instruction is not directly related to the addition of adalimumab to the client’s medication regimen.

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A client is receiving metronidazole for Clostridium difficile pseudomembranous colitis. Which information should the nurse include in this client's medication teaching plan?

Nursing Test Bank

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