The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy.
Which other medication or medication class, if ordered, would be a potential interaction concern?
Proton pump inhibitors
Calcium channel blockers
Loop diuretics
Phenytoin
The Correct Answer is C
Choice A rationale:
Proton pump inhibitors (PPIs) are used extensively for the treatment of gastric acid-related disorders, often over the long term, which raises the potential for clinically significant drug interactions in patients receiving concomitant medications.
However, there is no specific mention of a significant interaction between PPIs and aminoglycosides.
Choice B rationale:
Aminoglycoside antibiotics and calcium channel blockers can interact at the neuromuscular junctions. This interaction is of clinical significance because when these agents are given concurrently during the perioperative period they may lead to respiratory depression or prolonged apnea. However, this is not directly related to the therapeutic effect of aminoglycosides, but rather a side effect of their combined use.
Choice C rationale:
The loop-diuretics (ethacrynic acid, furosemide, bumetamide) and aminoglycoside antibiotics (kanamycin, gentamicin, tobramycin, amikacin, etc.) are important drugs frequently used to treat seriously ill patients. Not uncommonly both types of drugs are given to the same patient exposing that patient to the risk of a hearing loss (ototoxicity)5. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and aminoglycoside antibiotics.
Choice D rationale:
Phenytoin is a medication used to treat seizures. It has a complex pharmacokinetic profile and can interact with many other drugs. However, there is no specific mention of a significant interaction between phenytoin and aminoglycosides.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Hypoglycemia, also known as low blood sugar, is a condition where blood sugar levels fall below the standard range. It is often related to diabetes treatment. When blood glucose levels are too low, individuals may experience symptoms such as shakiness, which is why the statement “I will feel shaky” indicates an understanding of the manifestations of hypoglycemia.
Choice B rationale:
The statement “My skin will be warm and moist” does not accurately represent the symptoms of hypoglycemia. While sweating can be a symptom of hypoglycemia, it does not necessarily mean that the skin will feel warm and moist. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.
Choice C rationale:
The statement “I will be more thirsty than usual” is more commonly associated with hyperglycemia, or high blood sugar, rather than hypoglycemia. Thirst is not typically a symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.
Choice D rationale:
The statement “My appetite will be decreased” is not a typical symptom of hypoglycemia. In fact, hunger is a common symptom of low blood sugar. Therefore, this choice does not indicate a correct understanding of the manifestations of hypoglycemia.
Correct Answer is A
Explanation
Choice A rationale:
Reporting a near-miss using the facility’s recommended protocol and correcting the error on the MAR is the appropriate action. A “near-miss” in healthcare is a situation where an error could have happened, but didn’t, either by chance or timely intervention. It’s crucial to report these incidents as they provide valuable information for risk management and quality improvement. By analyzing near-misses, healthcare facilities can identify potential hazards and take preventive measures to ensure patient safety. Correcting the error on the MAR is also important to prevent the same mistake from happening in the future.
Choice B rationale:
Reporting the near-miss to the next shift before the next dose is due is not the best course of action. While it’s important to communicate any potential issues to the next shift, it’s more crucial to report the incident immediately using the facility’s recommended protocol. This allows for a timely investigation and corrective action. Waiting until the next shift could delay these processes and potentially put patient safety at risk.
Choice C rationale:
Correcting the MAR error but saying nothing because nothing happened is not an appropriate response. Even though the error did not result in any harm, it’s still important to report it. Near-misses are often indicators of underlying system issues that need to be addressed. By not reporting the incident, the opportunity to improve patient safety and prevent future errors is lost.
Choice D rationale:
Notifying the pharmacy about the error they almost caused is not the most appropriate action. While it’s important to communicate with the pharmacy if they were involved in the error, the first step should always be to report the near-miss using the facility’s recommended protocol. This ensures that the incident is properly documented and investigated, and that appropriate corrective actions are taken.
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