Mrs. Oza, age 69, has hypertension and has one functioning kidney. She loves chocolates and enjoys an alcoholic beverage twice a week. Her hobby is gardening and she goes for long walks despite having arthritis. Which one of the following pieces of information is likely to have the greatest significance if she is prescribed vancomycin?
She only has one functioning kidney
She remains outdoors for long periods of time
She has hypertension
She enjoys an alcoholic beverage twice a week
The Correct Answer is A
A. She only has one functioning kidney:
This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.
B. She remains outdoors for long periods of time:
While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.
C. She has hypertension:
Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.
D. She enjoys an alcoholic beverage twice a week:
While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Take small amounts of food:
This advice suggests eating small, frequent meals when experiencing diarrhea. It aims to reduce the workload on the digestive system and may help alleviate symptoms such as nausea and discomfort. However, while eating small amounts of food can be beneficial, increasing fluid intake is the priority to prevent dehydration associated with diarrhea.
B. Consume large quantities of milk and smoked meat:
Consuming large quantities of milk and smoked meat is not recommended when experiencing diarrhea. Dairy products, including milk, can worsen diarrhea in some individuals, especially those who are lactose intolerant. Similarly, smoked meat may be high in fat and difficult to digest, potentially aggravating gastrointestinal symptoms. Therefore, this advice is not appropriate for managing diarrhea.
C. Increase fluid intake:
Increasing fluid intake is essential when experiencing diarrhea to prevent dehydration. Diarrhea leads to the loss of fluids and electrolytes from the body, which can quickly lead to dehydration if not replenished. Encouraging the patient to drink water, clear broths, oral rehydration solutions, and other electrolyte-rich fluids helps replace lost fluids and maintain hydration levels, making this the correct choice.
D. Take a mild medication to treat the diarrhea along with the ciprofloxacin:
While it may be tempting to take a medication to alleviate diarrhea symptoms, it's crucial to consult a healthcare provider before taking any additional medications, especially when already taking antibiotics like ciprofloxacin. Some anti-diarrheal medications can interfere with the effectiveness of antibiotics or worsen gastrointestinal symptoms. Therefore, it's important to seek medical advice before taking any additional medications.
Correct Answer is B
Explanation
A. Bacteriostatics are narrow spectrum drugs, and bactericidal drugs are broad spectrum:
This statement is incorrect. The spectrum of activity (narrow vs. broad) of an antibiotic refers to the range of bacterial species that it can target, not whether it is bacteriostatic or bactericidal.
B. Bacteriostatic drugs inhibit bacterial growth, and bactericidal drugs actually kill bacteria:
This statement is correct. Bacteriostatic drugs work by inhibiting the growth and reproduction of bacteria without directly killing them, whereas bactericidal drugs directly kill bacteria.
C. Bacteriostatics work by inhibiting protein synthesis, and bactericidal drugs work by inhibiting nucleic acid synthesis:
This statement is incorrect. Both bacteriostatic and bactericidal drugs can target various bacterial cellular processes, including protein synthesis, nucleic acid synthesis, cell wall synthesis, and others. The mechanism of action is not a definitive factor in distinguishing between bacteriostatic and bactericidal drugs.
D. Bacteriostatic drugs actually kill bacteria, and bactericidal drugs inhibit bacterial growth:
This statement is incorrect. It contradicts the established definitions of bacteriostatic and bactericidal drugs. Bacteriostatic drugs inhibit bacterial growth without killing the bacteria, while bactericidal drugs directly kill bacteria.
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