The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with:
allergic reaction.
rhabdomyolysis.
Stevens-Johnson syndrome.
red man syndrome.
The Correct Answer is D
Allergic reaction: An allergic reaction can manifest in various ways, including rash, itching, and difficulty breathing. However, the specific symptoms described, along with the context of vancomycin administration, point to red man syndrome in this case.
Rhabdomyolysis: Rhabdomyolysis is a condition where damaged muscle tissue breaks down and releases a protein called myoglobin into the bloodstream. This can cause kidney damage, but the symptoms described do not align with rhabdomyolysis.
Stevens-Johnson syndrome: Stevens-Johnson syndrome is a severe skin reaction that can cause skin and mucous membranes to blister, peel, and can be life-threatening. While it can present with rash and other skin symptoms, the symptoms mentioned in the scenario are more characteristic of red man syndrome.
Red man syndrome: As mentioned earlier, red man syndrome is an allergic reaction to vancomycin characterized by flushing, rash, pruritus, and urticaria (hives), along with rapid heart rate and low blood pressure. It is specific to vancomycin and can be prevented or minimized by slowing down the infusion rate and administering antihistamines.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Discoloration of teeth: Tetracycline antibiotics can bind with calcium ions in teeth, leading to the development of yellow-gray-brown stains. This effect is particularly significant in developing teeth in children below the age of 8 and can result in permanent discoloration.
B. Anabolic change: This term doesn't specifically relate to the side effects of tetracycline. "Anabolic" generally refers to processes in the body that build up complex molecules from simpler ones. There's no direct connection between tetracycline and anabolic changes.
C. Cartilage damage: Tetracyclines, especially in high doses or with prolonged use, have been associated with potential adverse effects on cartilage. This is more relevant in individuals whose bones and cartilage are still growing, such as children. It can interfere with skeletal development.
D. Suppression of growth: Long-term use of tetracycline in children can interfere with bone growth and development. It can suppress the growth of bones and affect overall height. This is a significant concern when considering the use of tetracycline in pediatric patients.
Correct Answer is B
Explanation
A. Wear high-top shoes to avoid tendon rupture:
This statement is incorrect. Tendon rupture is a known side effect of fluoroquinolone antibiotics like ciprofloxacin, especially in certain populations. However, wearing high-top shoes does not prevent this. Patients should be educated about the signs of tendon pain, swelling, or inflammation and should be advised to stop the medication and contact their healthcare provider if they experience such symptoms.
B. Use a barrier method of birth control (condoms) during antibiotic use:
This statement is partially correct. Antibiotics like ciprofloxacin do not interfere with the efficacy of hormonal birth control methods like pills, patches, or injections. However, it's advisable to use a barrier method like condoms as an additional form of contraception while taking antibiotics. This is to prevent potential interactions and ensure maximum contraceptive effectiveness.
C. Do not use any bronchodilator inhalers while taking the drug:
This statement is incorrect. Ciprofloxacin does not interact negatively with bronchodilator inhalers. Patients can continue using their prescribed inhalers as directed by their healthcare provider, especially if they are being used for conditions like asthma or chronic obstructive pulmonary disease (COPD).
D. Stop the medication as soon as you feel better:
This statement is incorrect. It's crucial for patients to complete the entire course of antibiotics as prescribed, even if they start feeling better before the course is finished. Stopping antibiotics prematurely can lead to incomplete eradication of the infection, potentially allowing the bacteria to develop resistance and cause a recurrence of the illness.
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