A nurse is reinforcing teaching about vancomycin with a client who has an infection. Which of the following information should the nurse include in the teaching?

A.Goldenseal:

Goldenseal is a plant commonly used in herbal medicine, but it is not a drug that specifically inhibits bacterial beta-lactamase. While goldenseal may have antimicrobial properties, it is not typically used as a beta-lactamase inhibitor in the treatment of bacterial infections.

B. Ceftriaxone (Rocephin):

Ceftriaxone is a third-generation cephalosporin antibiotic. While it is an effective antibiotic for treating a wide range of bacterial infections, it does not have beta-lactamase inhibitor properties. Instead, ceftriaxone is susceptible to degradation by beta-lactamase enzymes produced by certain bacteria.

C. Penicillin:

Penicillin is one of the earliest discovered and most widely used beta-lactam antibiotics. However, many bacteria have developed resistance to penicillin by producing beta-lactamase enzymes. Penicillin itself does not inhibit beta-lactamase; instead, it is often combined with beta-lactamase inhibitors to enhance its effectiveness against beta-lactamase-producing bacteria.

D. Zosyn (piperacillin/tazobactam):

Zosyn is a combination antibiotic containing piperacillin, a broad-spectrum penicillin antibiotic, and tazobactam, a beta-lactamase inhibitor. Tazobactam inhibits the action of beta-lactamase enzymes produced by bacteria, allowing piperacillin to exert its antibacterial effects without being degraded by beta-lactamase. Therefore, Zosyn is the correct answer as it contains a drug that inhibits bacterial beta-lactamase.

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.