The nurse is caring for a client who has an order for no food or drink by mouth and is receiving intravenous acyclovir. To prevent nephrotoxicity, what is the nurse's action?

Encourage oral fluid intake during the infusion and for 2 hours after the infusion.

Monitor urinary output every 30 minutes.

Provide a low-protein diet for one day before and two days after the acyclovir infusion.

Administer intravenous normal saline boluses, as ordered.

Answer and Explanation

The Correct Answer is A

a. This is the correct answer because maintaining adequate hydration helps prevent nephrotoxicity associated with acyclovir. Encouraging fluid intake during and after the infusion helps flush the drug through the kidneys.

b. While monitoring urinary output is important, it alone may not be sufficient to prevent nephrotoxicity.

c. Providing a low-protein diet is not a standard intervention for preventing acyclovir-induced nephrotoxicity.

d. Administering intravenous normal saline boluses, as ordered, can help maintain hydration and prevent nephrotoxicity. However, encouraging oral fluid intake is a more direct and immediate measure during acyclovir infusion.

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Correct Answer is B

Explanation

a) Vitamin D levels may be affected by long-term glucocorticoid use, but the described symptoms are more indicative of potential glucocorticoid-related side effects, such as Cushingoid features, which warrant liver function tests.

b) Liver function tests are appropriate to assess the impact of long-term glucocorticoid use on the liver, as these medications can affect liver function.

c) Serum electrolytes are important to monitor, but the specific symptoms mentioned (full cheeks, hump of fat) are not typically associated with electrolyte imbalances.

d) A tuberculin skin test is unrelated to the observed symptoms and is not typically ordered based on the physical features described.

A. Stop all antibiotics and implement strict use of alcohol-based hand sanitizer. B. Discontinue the cephalosporin and call the provider to recommend vancomycin or metronidazole. C. Call the provider to request an additional antibiotic to override the effects of the cephalosporin. D. Increase the dose of cephalosporin and provide isolation measures.

Correct Answer is B

Explanation

a) Stopping all antibiotics and implementing strict use of alcohol-based hand sanitizer is not the appropriate response to the observed symptoms. The focus should be on addressing the potential infection.

b) The symptoms suggest the possibility of Clostridium difficile infection, and discontinuing the cephalosporin is crucial. Vancomycin or metronidazole is commonly used to treat C. difficile infection.

c) Requesting an additional antibiotic to override the effects of the cephalosporin is not the appropriate course of action. The focus should be on discontinuing the causative antibiotic.

d) Increasing the dose of cephalosporin is contraindicated in the presence of suspected C. difficile infection. Isolation measures may be implemented, but the priority is discontinuing the causative antibiotic and initiating appropriate treatment for the infection.

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The nurse is caring for a client who has an order for no food or drink by mouth and is receiving intravenous acyclovir. To prevent nephrotoxicity, what is the nurse's action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes the client's cheeks appear full, and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory tests?

Correct Answer is B

Explanation

A client receiving a cephalosporin has passed six distinct-smelling, unformed stools in the first 6 hours of the nurse's shift. What is the nurse's best action?

Correct Answer is B

Explanation

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