A patient is taking azithromycin. Which nursing intervention(s) would the nurse plan to implement for this patient? (Select all that apply.)

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RN ATI Capstone Pharmacology 2 Quiz Questions

Question 1 of 5

A patient is taking azithromycin. Which nursing intervention(s) would the nurse plan to implement for this patient? (Select all that apply.)

Correct Answer: A

Rationale: Azithromycin is a macrolide antibiotic that can cause hepatotoxicity, so periodic liver function tests are necessary. Intravenous azithromycin should be diluted as per protocol, typically in 250-500 mL of fluid, not 50 mL. Loose stools or diarrhea may indicate Clostridium difficile-associated diarrhea, a serious adverse effect. Superinfections, such as oral thrush or vaginal yeast infections, should be reported promptly. Teaching the patient to take the oral drug 1 hour before or 2 hours after meals ensures optimal absorption. Avoiding antacids around the time of administration prevents interference with absorption.

Question 2 of 5

A patient requires a high dose of a new antihypertensive medication because the new medication has a significant first-pass effect. What does this mean?

Correct Answer: C

Rationale: The first-pass effect refers to the extensive metabolism of a drug in the liver before it reaches systemic circulation. This reduces the bioavailability of the drug, necessitating a higher dose to achieve therapeutic effects. The medication does not need to pass through the bloodstream multiple times (A), nor is it primarily excreted in the kidneys (B). The drug’s effectiveness is not related to cumulative dosing (D).

Question 3 of 5

A client is receiving methocarbamol (Robaxin) as an adjunct to physical therapy for the relief of painful muscle discomfort. Which of the following is not true regarding the use of the medication?

Correct Answer: C

Rationale: Methocarbamol can cause urine discoloration, and rapid intravenous administration may lead to hypotension and bradycardia. However, the use of cold or allergy medicines does not lessen its side effects. The parenteral form is contraindicated in patients with liver damage due to the risk of hepatotoxicity. This statement is incorrect and not supported by the drug's pharmacology.

Question 4 of 5

A nurse is instructing a client regarding carbidopa-levodopa (Sinemet) for the treatment of Parkinson’s disease. The nurse tells the client which of the following indicates an overdose of the medication?

Correct Answer: A

Rationale: An overdose of carbidopa-levodopa (Sinemet) can cause excessive dopaminergic stimulation, leading to dyskinesias or difficulty performing voluntary movements. Increased blood pressure, decreased appetite, and black tarry stools are not typical signs of overdose. Therefore, difficulty with voluntary movement is the correct indicator of overdose.

Question 5 of 5

A 56-year-old man with progressive, chronic renal impairment is awaiting renal replacement therapy. His treatment includes calcium carbonate tablets, furosemide, irbesartan and amlodipine. He is admitted severely unwell with a BP of 40 by palpation, pulse 112. An ECG shows a broad complex tachycardia with no P waves. Serum Ca2+ is 2.3 mmol/L, PO4 1.7 mmol/L, creatinine 785 μmol/L, Na+ 142 mmol/L, K+ 7.4 mmol/L. Which of the following would be appropriate management?

Correct Answer: C

Rationale: Severe hyperkalemia (K+ 7.4 mmol/L) in renal failure causes broad complex tachycardia, risking arrest. Amiodarone treats arrhythmias but not hyperkalemia's cause. Digoxin is contraindicated in hyperkalemia and renal failure. IV calcium gluconate stabilizes cardiac membranes, countering potassium's depolarizing effect, appropriate immediate management. Pacing or colestyramine (potassium binder) are secondary. Calcium's rapid action protects the heart, buying time for dialysis, critical in this life-threatening scenario.

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