When exposed to repeated cycles of antibiotics, within days bacteria can evolve a new adaptation, by remaining dormant for the treatment period to survive antibiotic stress. The results show for the first time that bacteria can develop a biological timer to survive antibiotic exposure 

A.     a delayed (type IV) hypersensitivity reaction

B.     the fact that the client may have chewed the capsules prior to swallowing them

C.     superinfection following the eradication of normal oral flora

D.    a type I hypersensitivity reaction

Candidal superinfections may result from the use of tetracycline. The superinfection results from the elimination of normal flora and is not a hypersensitivity reaction. This is not the result of physical contact between the drug and the oral mucosa. Type IV hypersensitivity is often called delayed-type hypersensitivity as the reaction takes 2 to 3 days to develop. A type I hypersensitivity reaction is triggered by an innocuous foreign substance (like dust, pollen, or animal dander) that would cause no problems in most people.

Reference: Karch, Amy M., Focus on Nursing Pharmacology, 7^th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 9: Antibiotics, p. 123.

 

 

Ciprofloxacin 500mg P.O. 2x daily for 14 days

Men’s Daily Multivitamin P.O. 1x daily

Eliquis 2.5mg P.O. 2x daily 

Loratadine 10mg P.O. 1x daily 

St. John’s Wort 5-6 drops P.O. 3x daily 

 

The doctor instructed him to take 500mg of acetaminophen every 6 hours as needed. 

 

 

 

Some things to know about Cipro:

 

·      Achilles tendon rupture is most common in people over the age of 60

·      Achilles tendon rupture is more common with groups of people who have pre-existing health problems such as diabetes mellitus, or prolonged steroid use for lung problems

·      Rupture can occur from the first dose or can be over long periods of time

 

Acetylcysteine is the antidote to acetaminophen overdose. Naloxone treats opioid overdoses. Given the high dose of acetaminophen, watchful waiting would be inadequate. Lactated Ringer’s would not be therapeutically beneficial. 

Reference: Karch, Amy M., Focus on Nursing Pharmacology, 7^th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 16: Anti-Inflammatory, Antiarthritis, and Related Agents, p. 275.

A.      Administration of acetylcysteine as prescribed

B.      Watchful waiting

C.      Administration of naloxone as prescribed

D.      Intravenous administration of Lactated Ringer’s

In order to achieve maximum therapeutic benefit, it is important for the client to take the drug exactly as prescribed. The client's statement suggests that the client does not appreciate or understand this fact. There is no evidence of pathological thought patterns or ineffective coping. The statement reflects an inaccurate conclusion regarding the symptom management of this disorder.

Reference: Karch, Amy M., Focus on Nursing Pharmacology, 7^th ed., Philadelphia, Wolters Kluwer, 2017, Chapter 11: Antifungal Agents, p. 171,175.

A.      deficient knowledge related to correct use of griseofulvin

B.      effective therapeutic regimen management related to symptom identification

C.      disturbed thought processes related to appropriate use of griseofulvin

 ineffective coping related to self-medication 

The risk for nephrotoxicity is higher in older patients because with advancing age, renal function diminishes and drug excretion becomes less effective. Serious adverse effects or cumulative toxicity can result. It is important for the nurse to be aware of and assess the older patient's neurologic, cardiac, and respiratory functions. However, they would not be as important as the renal function because of the medication being taken.

Reference: Karch, A.M. Focus on Nursing Pharmacology, 7th ed., Philadelphia: Wolters Kluwer Health, 2017, Chapter 10: Antiviral Agents, p. 144, box 10.2.

 

A.      Neurologic function

B.      Renal function

C.      Cardiac function

D.     Respiratory function

And Broad-spectrum anti-infectives are agents that interfere with biochemical reactions in many different kinds of microorganisms.