A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins.
The nurse determines that the teaching was successful when the patient identifies which of the following?

Choice A rationale:

Wear protective clothing and sunscreen when outside. Rationale: Sulfonamide antibiotics, a type of medication mentioned in the question, can increase the skin's sensitivity to sunlight, leading to photosensitivity reactions. To reduce the effects of photosensitivity, the client should be instructed to wear protective clothing that covers the skin and to apply sunscreen with a high sun protection factor (SPF) when going outdoors. This helps shield the skin from harmful UV rays, reducing the risk of sunburn and other adverse reactions.

Choice B rationale:

Increase fluid intake. Rationale: Increasing fluid intake is a general recommendation for clients taking sulfonamide antibiotics to minimize the risk of crystalluria, a side effect that can result from inadequate hydration. Crystalluria is the formation of crystals in the urine and can lead to kidney stones. While staying hydrated is essential, it is not specifically related to reducing photosensitivity, which is the focus of this question.

Choice C rationale:

Avoid lights while indoors. Rationale: Avoiding lights while indoors is not a standard precaution to reduce the effects of photosensitivity caused by sulfonamide antibiotics. Photosensitivity primarily refers to the skin's heightened sensitivity to sunlight. Being indoors under regular lighting conditions should not significantly impact photosensitivity. The key precautions are related to outdoor sun exposure.

Choice D rationale:

Wear protective footwear. Rationale: Wearing protective footwear is not a standard precaution to reduce photosensitivity effects caused by sulfonamide antibiotics. Photosensitivity primarily affects the skin, not the feet. While protective footwear may be recommended in specific situations, such as in a construction or industrial setting, it is not directly related to reducing the risk of photosensitivity reactions.

Choice A rationale:

Macrolides are typically broad-spectrum antibiotics, not narrow-spectrum. They are effective against a wide range of bacteria, making them a valuable option for various infections.

Choice B rationale:

Macrolides are generally well-tolerated, and they are not contraindicated in clients with renal dysfunction. In fact, macrolides like azithromycin are often preferred in such cases due to their minimal renal excretion.

Choice C rationale:

Macrolides, specifically erythromycin, have been associated with ototoxicity, which can lead to hearing impairment. This side effect is relatively rare but can occur, especially with high doses or prolonged use. It's important for healthcare providers to monitor for this potential adverse effect.

Choice D rationale:

Macrolides are often used as an alternative for clients who are allergic to penicillins, so they can be used in this population when appropriate. The cross-reactivity between these drug classes is relatively low, and macrolides can be a suitable choice for penicillin-allergic individuals.