A nurse is administering tetracycline, a broad-spectrum antibiotic, to a patient who has acne vulgaris.
The nurse should monitor the patient for which of the following adverse effects of this medication? (Select all that apply.)

The nurse should include these instructions in the teaching because:

• Tetracycline should be taken on an empty stomach to avoid interference with absorption.

• Dairy products should be avoided while taking this drug because they contain calcium, which can form insoluble complexes with tetracycline and reduce its effectiveness.

• Sunscreen or sun avoidance should be used while taking this drug because it can cause photosensitivity, which increases the risk of sunburn and skin damage.

• Plenty of fluids should be drunk while taking this drug because it can cause nephrotoxicity, which is damage to the kidneys.

Choice E is wrong because vaginal itching or discharge is not a common side effect of tetracycline.It may indicate a superinfection, which is a secondary infection caused by the disruption of normal flora by antibiotics.

This should be reported to the health care provider as soon as possible.

They are effective against a few types of organisms.Narrow spectrum antibiotics are antibiotics that work against a limited range of bacteria, usually either gram-positive or gram-negative.They are more specific and less likely to cause resistance or disrupt the normal flora.

Choice A) They are effective against gram-positive bacteria only.This is not true because some narrow spectrum antibiotics can also target gram-negative bacteria, such as aminoglycosides.

Choice B) They are effective against gram-negative bacteria only.This is not true because some narrow spectrum antibiotics can also target gram-positive bacteria, such as vancomycin.

Choice C) They are effective against one type of organism.This is too restrictive because narrow spectrum antibiotics can work against more than one type of organism, such as penicillins that target both streptococci and staphylococci.