week 8 REVIEW TEST SUBMISSION REVISION MATERIAL, NURS , A+ Guaranteed...

Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? Response Feedback : Before applying silver sulfadiazine, it is necessary to cleanse the wound completely and remove dead or burned skin and other debris. It would be inappropriate to perform wound care after the application of the drug and it should be applied in a thin layer no more than about 1/16 inch. Application of topical sulfonamides is a sterile, not clean, procedure. A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to Response Feedback : To minimize the risk of developing nephrotoxicity, the patient should stay well hydrated by drinking at least eight 8-oz glasses of water daily. Eating light meals or taking the drug on an empty stomach would not decrease the risk of developing nephrotoxicity. A nurse should never alter the drug dosage without consulting the prescriber. Which of the following is critical to helping prevent development of resistant strains of microbes in patients? Response Feedback : Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of these agents to the treatments of specific pathogens known to be sensitive to the drug being used. Drug dosages are also important in preventing the development of resistance. However, the duration of drug use is critical to ensure that microbes are completely eliminated and not given the chance to grow and develop resistant strains. It is hard to convince patients that the timing of the dose and length of time they continue to take the drug are important. Patients who stop the drug when they start to feel better encourage the emergence of resistant strains. A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining Response Feedback : Patients on long-term clindamycin therapy should have a baseline complete blood count because of clindamycin's potential to induce blood dyscrasias. Blood sugar levels, auditory abilities, and liver enzymes need not to be evaluated for long-term or short-term therapy. A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause Response Feedback : Because of the potential for nephrotoxicity and ototoxicity that is associated with gentamicin, other medications that may lead to these same adverse effects must be used with caution. Gentamicin does not typically affect immune function, ICP, or hematopoiesis. A nurse has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow- spectrum antibiotics whenever possible? Response Feedback The benefit of a narrow-spectrum antimicrobial agent is that it limits the potential for adverse effects, such as superinfection. In a : superinfection, an antibiotic suppresses all susceptible microbes, including the body's natural flora, which may keep other microbes in check. In the absence of these bacteria, nonsusceptible microbes can proliferate. Narrow-spectrum antibiotics do not lack demonstrated efficacy and they do not necessarily require a shorter duration of treatment. All antimicrobial drugs have the potential to impact subsequent C&S testing. A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Response Feedback : The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity. Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of Response Feedback : Patients with cardiac arrhythmias may be at risk for developing quinine-induced dysrhythmias and patients treated with quinine have shown prolonged Q-T intervals. Low bone density, diabetes, and COPD are not health problems that preclude the use of quinine in the treatment of chloroquine-resistant malaria. A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication Response Feedback : After oral administration, ganciclovir is absorbed poorly from the GI tract. Bioavailability is increased when the medication is administered with a high-fat meal. High-protein meals, orange juice, and an empty stomach will not help increase bioavailability of this drug.