A nurse is reviewing the signs and symptoms of a fungal superinfection with a client.
The client demonstrates understanding of the information when he identifies which of the following as suggesting a fungal superinfection?

Choice A rationale:

Tetracyclines are not narrow-spectrum antibiotics. They are broad-spectrum antibiotics. Tetracyclines are effective against a wide range of bacteria, including both Gram-positive and Gram-negative organisms. This is important in treating various infections, but it also means they can disrupt the normal flora of the gut, potentially leading to issues like antibiotic-associated diarrhea.

Choice B rationale:

Tetracyclines may cause permanent discoloration of the teeth in children. This is a well-known adverse effect of tetracycline antibiotics. It primarily occurs in children under the age of 8, whose teeth are still developing. Tetracyclines can bind to calcium ions in teeth, leading to a yellow or grayish discoloration. This is why tetracyclines are generally avoided in children and pregnant women.

Choice C rationale:

Tetracyclines can be used when penicillins are contraindicated. Tetracyclines and penicillins are different classes of antibiotics, and being contraindicated for one does not necessarily mean the other is also contraindicated. Tetracyclines can be an alternative for patients who cannot tolerate penicillins due to allergies or other contraindications.

Choice D rationale:

Tetracyclines are not contraindicated in children younger than 9 years. This statement is not accurate. Tetracyclines are contraindicated in children under the age of 8 due to the risk of tooth discoloration. After the age of 8, tetracyclines can be used in children, but caution is still required.

Choice E rationale:

Tetracyclines are not used to treat influenza. Influenza is caused by viruses, not bacteria, and tetracyclines are antibiotics that target bacteria. Influenza is typically treated with antiviral medications, such as oseltamivir (Tamiflu).

Choice A rationale:

Aminoglycosides are known to have nephrotoxic effects. Nephrotoxicity refers to kidney toxicity, and aminoglycosides can cause damage to the renal tubules, leading to impaired kidney function. The nurse should be alert to this potential toxicity when administering these drugs, as it can result in kidney dysfunction, altered serum creatinine levels, and electrolyte imbalances.

Choice B rationale:

Cardiotoxicity is not typically associated with aminoglycosides. These antibiotics primarily affect the kidneys and the inner ear. There is no direct relationship between aminoglycosides and cardiac toxicity.

Choice C rationale:

Hepatotoxicity refers to liver toxicity and is not a common side effect of aminoglycosides. Aminoglycosides are primarily metabolized in the kidneys and are excreted through urine, making kidney toxicity a more significant concern.

Choice D rationale:

Cytotoxicity is a broad term that refers to the toxicity of cells. Aminoglycosides do not typically cause generalized cytotoxic effects in the body. Their primary toxicities are related to specific organ systems, such as the kidneys and the inner ear.