A nurse is reviewing laboratory results for a client who has a fungal infection and is receiving itraconazole therapy.
Which of the following findings should alert the nurse to a potential adverse effect of this medication?

Elevated serum creatinine level

Decreased serum potassium level

Increased serum glucose level

Decreased white blood cell count.

Answer and Explanation

The Correct Answer is A

This is because itraconazole can cause renal impairment and decreased urine output as an adverse effect. A normal serum creatinine level is 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females.

Choice B is wrong because decreased serum potassium level is not an adverse effect of itraconazole. Itraconazole can cause hypokalemia, which is a low level of potassium in the blood, but this is usually due to fluid retention and heart failure caused by the drug. A normal serum potassium level is 3.5 to 5.0 mEq/L.

Choice C is wrong because increased serum glucose level is not an adverse effect of itraconazole. Itraconazole can cause hyperglycemia, which is a high level of glucose in the blood, but this is usually due to diabetes mellitus or steroid use in patients taking the drug. A normal serum glucose level is 70 to 100 mg/dL.

Choice D is wrong because decreased white blood cell count is not an adverse effect of itraconazole. Itraconazole can cause leukopenia, which is a low level of white blood cells in the blood, but this is usually due to bone marrow suppression or infection in patients taking the drug. A normal white blood cell count is 4,500 to 11,000 cells/mm3.

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Correct Answer is B

Explanation

Inappropriate antibiotic use leads to the emergence of resistance.This is a well-established fact that is supported by the CDC and other organizations.Resistance can occur when antibiotics are used unnecessarily, excessively, or incorrectly, and can lead to infections that are harder to treat and more costly.

Choice A is wrong because antibiotic guidelines in critical care do not necessarily reduce the hospital length of stay.Although some studies have suggested that adherence to pneumonia guidelines may improve outcomes in severe pneumonia, other studies have found no significant effect of antibiotic stewardship on hospital length of stay or mortality in critically ill patients.

Therefore, this statement is not universally true.

Choice C is wrong because antibiotic dosing has a significant effect on antimicrobial resistance.Optimal dosing of antibiotics can help eradicate infections, prevent relapse, and minimize the selection of resistant bacteria.Conversely, suboptimal dosing can lead to treatment failure, prolonged infection, and increased resistance.

Therefore, antibiotic dosing should be carefully adjusted according to the pharmacokinetic and pharmacodynamic properties of the drug and the patient.

Choice D is wrong because an antibiotic stewardship programme leads to a decrease in antimicrobial resistance, not an increase.An antibiotic stewardship programme is a coordinated effort to improve and measure the appropriate use of antibiotics by promoting the selection of the optimal drug regimen, dose, duration, and route of administration.Such programmes have been shown to reduce antibiotic consumption, resistance rates, adverse events, and costs in various settings.

Therefore, this statement is false.

A. Take the medication with an antacid to reduce gastric irritation. B. Drink plenty of fluids to prevent crystalluria. C. Avoid sexual intercourse until treatment is completed. D. Chew the tablets thoroughly before swallowing. E. Electrocardiogram.

Correct Answer is C

Explanation

The client should avoid sexual intercourse until treatment is completed.This is because trichomoniasis is a sexually transmitted infection that can be passed between partners during penile-vaginal sex or through transmission of infected vaginal fluids or fomites among women who have sex with women. Therefore, abstaining from sex until both partners are cured can prevent reinfection and transmission.

Choice A is wrong because taking the medication with an antacid can reduce its absorption and effectiveness.Tinidazole should be taken with food to minimize gastrointestinal side effects.

Choice B is wrong because drinking plenty of fluids to prevent crystalluria is not relevant for tinidazole.

Crystalluria is a condition where crystals form in the urine, which can cause kidney stones or damage.This is a potential complication of some antibiotics, such as sulfonamides, but not tinidazole.

Choice D is wrong because chewing the tablets thoroughly before swallowing is not necessary for tinidazole.Tinidazole tablets are film-coated and can be swallowed whole with water.

Chewing the tablets may alter their release and absorption, and may also cause a bitter aftertaste.

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A nurse is reviewing laboratory results for a client who has a fungal infection and is receiving itraconazole therapy. Which of the following findings should alert the nurse to a potential adverse effect of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement is true regarding antimicrobial stewardship?

Correct Answer is B

Explanation

A nurse is caring for a client who has trichomoniasis and is prescribed tinidazole. Which of the following instructions should the nurse give to the client?

Correct Answer is C

Explanation

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A nurse is reviewing laboratory results for a client who has a fungal infection and is receiving itraconazole therapy.
Which of the following findings should alert the nurse to a potential adverse effect of this medication?