On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Monitor for signs of sodium and fluid retention.

Wound and blood specimens for culture and sensitivity.

Complete blood count and serum electrolytes.

Irrigation and topical antibiotic application to wound area.

Answer and Explanation

The Correct Answer is B

Choice A reason: Monitoring for signs of sodium and fluid retention is not relevant to this situation, as broad spectrum antibiotics do not affect sodium or fluid balance. Sodium and fluid retention may be caused by other conditions such as heart failure, kidney disease, or liver disease.

Choice B reason: Obtaining wound and blood specimens for culture and sensitivity is most important before administering the first dose of a broad spectrum antibiotic, as this can help identify the specific type and strain of bacteria causing the infection and determine which antibiotic is most effective against it. Broad spectrum antibiotics are effective against a wide range of bacteria, but they may also kill beneficial bacteria and increase the risk of resistance or superinfection.

Choice C reason: Obtaining a complete blood count and serum electrolytes is not necessary before administering the first dose of a broad spectrum antibiotic, as these tests do not provide information about the type or severity of infection. A complete blood count may show an elevated white blood cell count or other changes in response to infection, but it does not identify the causative organism. Serum electrolytes may show abnormalities due to dehydration, vomiting, diarrhea, or other factors, but they do not indicate infection.

Choice D reason: Performing irrigation and topical antibiotic application to wound area is not sufficient before administering the first dose of a broad spectrum antibiotic, as this may not reach all sites of infection or eradicate all bacteria. Irrigation and topical antibiotic application may help clean and prevent further contamination of wound area, but they do not replace systemic antibiotic therapy.

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Correct Answer is C

Explanation

Choice A reason: Stopping the oral contraceptive immediately is not necessary and may increase the risk of unintended pregnancy. Erythromycin can reduce the effectiveness of oral contraceptives by interfering with their metabolism, but it does not make them completely ineffective.

Choice B reason: Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between erythromycin and oral contraceptives. The interaction can occur regardless of the timing of the doses.

Choice C reason: Using an additional form of contraception is the best instruction for the client who is taking an oral contraceptive and erythromycin. This can prevent pregnancy in case the oral contraceptive fails due to the interaction with erythromycin. The additional form of contraception should be non-hormonal, such as a barrier method or a copper intrauterine device.

Choice D reason: Avoiding prolonged exposure to direct sunlight is a good advice for anyone taking erythromycin, as it can cause photosensitivity and increase the risk of sunburn. However, this is not related to the interaction with oral contraceptives and does not affect their efficacy.

A. Instruct the client that it is necessary to take nothing but water with the medication. B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk. C. Withhold the medication until the client's breakfast tray is available on the unit. D. Consult with a pharmacist about scheduling the dose one hour after the client eats.

Correct Answer is A

Explanation

Choice A reason: Risedronate is a bisphosphonate that is used to treat osteoporosis by inhibiting bone resorption. It should be taken on an empty stomach with a full glass of water at least 30 minutes before any other food, beverage, or medication. This is because food, milk, and antacids can interfere with the absorption of risedronate and reduce its effectiveness.

Choice B reason: Milk contains calcium, which can bind to risedronate and prevent its absorption. Therefore, the client should not drink milk with or within 2 hours of taking risedronate.

Choice C reason: Withholding the medication until the client's breakfast tray is available is not appropriate, as it would delay the administration of risedronate and disrupt the dosing schedule. The client should take risedronate as soon as possible after waking up and before eating anything.

Choice D reason: Consulting with a pharmacist about scheduling the dose one hour after the client eats is not necessary, as risedronate should be taken at least 30 minutes before any food or beverage. Taking risedronate one hour after eating may not ensure adequate absorption of the drug.

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On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is C

Explanation

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

Correct Answer is A

Explanation

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