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A nurse is teaching a client who has been prescribed tetracycline, a tetracycline antibiotic, for acne vulgaris.
Which of these instructions should the nurse include in the teaching? (Select all that apply.)

Take the drug on an empty stomach.

Avoid dairy products while taking this drug.

Use sunscreen or avoid exposure to sunlight.

Drink plenty of fluids while taking this drug.

Report any vaginal itching or discharge.

Answer and Explanation

Correct Answer : A,B,C,D

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.

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Correct Answer is ["A","B","C"]

Explanation

Here is why:

• Choice A:Monitor the client’s serum creatinine level.

This is correct because vancomycin can cause nephrotoxicity (damage to the kidneys) and serum creatinine is a marker of kidney function.A high serum creatinine level indicates impaired kidney function and may require dose adjustment or discontinuation of vancomycin.

• Choice B:Monitor the client’s serum vancomycin level.

This is correct because vancomycin has a narrow therapeutic range, meaning that there is a small difference between the effective dose and the toxic dose.Monitoring the serum vancomycin level can help to ensure that the drug is within the therapeutic range and avoid toxicity or suboptimal efficacy.

• Choice C:Infuse the drug over at least 60 minutes.

This is correct because vancomycin can cause a hypersensitivity reaction called “red man syndrome” or “red neck syndrome”, which is characterized by flushing, itching, rash, hypotension and tachycardia.

This reaction is not an allergy but a result of histamine release due to rapid infusion of vancomycin.Infusing the drug over at least 60 minutes can reduce the risk of this reaction.

• Choice D:Observe the client for signs of ototoxicity.

This is incorrect because vancomycin is not known to cause ototoxicity (damage to the ears) in humans.Ototoxicity has been reported in animal studies and in vitro studies, but not in clinical trials or case reports involving humans.

Therefore, there is no need to monitor for signs of ototoxicity such as hearing loss, tinnitus or vertigo.

A. Antibiotic guidelines in critical care reduce the hospital length of stay. B. Inappropriate antibiotic use leads to the emergence of resistance. C. Antibiotic dosing has little effect on antimicrobial resistance. D. An antibiotic stewardship programme leads to an increase in antimicrobial resistance.

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.

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A nurse is teaching a client who has been prescribed tetracycline, a tetracycline antibiotic, for acne vulgaris. Which of these instructions should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer vancomycin, a glycopeptide antibiotic, to a client with a severe infection caused by Clostridium difficile. The nurse should select all that apply:

Correct Answer is ["A","B","C"]

Explanation

Which statement is true regarding antimicrobial stewardship?

Correct Answer is B

Explanation

The nurse identifies which host factor as the most important when choosing an antimicrobial drug?

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The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what?

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A nurse is teaching a client who has been prescribed tetracycline, a tetracycline antibiotic, for acne vulgaris.
Which of these instructions should the nurse include in the teaching? (Select all that apply.)