NURS 317 Unit 7 Pharm Chapter 11 Flashcards
A parent has informed the nurse that she has been applying an OTC antifungal to her infant’s buttocks and perineal region. What question related to safety should the nurse ask the parent?
A) “Does your infant have any food allergies that you’re aware of yet?”
B) “Did you take any antifungal medications while you were pregnant?”
C) “Did you explore any herbal or alternative remedies before starting to use this ointment?”
D) “Are there any open wounds on the areas where you’re putting the ointment?”
D) “Are there any open wounds on the areas where you’re putting the ointment?”
Rationale:Topical agents should not be used over open or draining areas that would increase the risk of systemic absorption and toxicity. Allergy status is always important, but questions of applying the medication over open areas would be a safety priority; no aspect of the scenario suggests a hypersensitivity response. Previous use of herbal remedies may be relevant but is not a high priority. The mother’s use of antifungals while pregnant is not relevant.
When caring for a client receiving amphotericin B, the nurse includes what assessments in the plan of care? Select all that apply.
A) Orientation
B) Vision
C) Renal function
D) Reflexes
E) Oxygen saturation
F) Liver function
A) Orientation
C) Renal function
D) Reflexes
F) Liver function
Rationale:When administering amphotericin B, it is important to assess the client’s liver and renal function and monitor orientation and reflexes because these are the most vulnerable areas for adverse effects of the drug. Vision and oxygen saturation monitoring may be indicated due to the source of the infection but are not associated with adverse effects from amphotericin B.
Amphotericin B is contraindicated for use during pregnancy.
A) FALSE
B) TRUE
A) FALSE
Rationale:Amphotericin B has been used successfully during pregnancy, but it should be used cautiously and only if benefits outweigh risks.
The incidence of fungal infections has recently dropped due to the advances in drug therapy.
A) TRUE
B) FALSE
B) FALSE
Rationale:The incidence of fungal infections has increased with the rising number of immunocompromised individuals.
A client has been diagnosed with a fungal infection and been prescribed a topical antifungal medication. What assessment question should the nurse ask when addressing the possible etiology of the fungal infection?
A) “Have you received any vaccinations in the past few weeks?”
B) “When was the last time you visited a hospital or clinic?”
C) “Have you been prescribed any antibiotics in the recent past?”
D) “Were you prone to acne when you were younger?”
C) “Have you been prescribed any antibiotics in the recent past?”
Rationale:A course of antibiotics can often precipitate a fungal infection. Hospital visits, immunizations, and a history of acne are not identified as risk factors or causes of fungal infections.
A nurse who provides care on a medical unit is reviewing the use of topical antifungal agents. The nurse should recognize what characteristic of these medications?
A) Application site reactions rarely occur with topical application.
B) The drugs are often too toxic for systemic administration.
C) The drugs can be used for an indefinite period of time as long as the client is not allergic.
D) These drugs are associated with significant drug–drug interactions.
B) The drugs are often too toxic for systemic administration
Rationale:The antifungal agents reserved for topical use are often too toxic to be given systemically. Systemic antifungals are associated with numerous drug–drug interactions. Topical agents are not absorbed systemically, so they do not have drug–drug interactions. Most of the topical agents are used for a specific period of time, usually no longer than 4 to 6 weeks depending on the drug.
The nurse is teaching peers about fungal infections. How does the nurse best describe the cell membrane of a fungal cell?
A) Contains ergosterol
B) Contains mycosis
C) Contains monosaccharides
D) Has a soft cell wall
A) Contains ergosterol
Rationale:Ergosterol is a steroid-type protein found in the cell membrane of fungi, similar in configuration to adrenal hormones and testosterone. Fungi have a hard cell wall. The cell membrane contains polysaccharides. Mycosis is a disease caused by a fungus.
A client’s previous medical history includes mycosis. What conclusion should the nurse draw from this fact?
A) The client had a superficial infection of the skin related to fungal invasion.
B) The client has an underlying immune disorder that caused a fungal infection.
C) The client has had a disease that was caused by a fungus.
D) The client had an infection involving an overgrowth of opportunistic organisms.”
C) The client has had a disease that was caused by a fungus.
Rationale:Mycosis refers to a disease that is caused by a fungus. Mycosis is unrelated to immune disorders. A superinfection refers to an infection that involves an overgrowth of opportunistic organisms. In some cases, a superinfection can be due to a fungal infection. Mycosis refers to a fungal infection that can be localized, superficial, or systemic.
The client is diagnosed with a Candida infection of the mouth, which the nurse documents as what?
A) Ringworm
B) Dermatophytes
C) Thrush
D) Tinea cruris
C) Thrush
Rationale:Thrush is a Candida infection of the mouth, often identified by small white spots on the tongue most commonly seen in newborns or clients who are immunocompromised. Ringworm is caused by tinea infection, not Candida, and is usually found on the skin and not in the mouth. Fungi known as dermatophytes include tinea infections, of which Candida infections are only one small subgrouping. Tinea cruris is also called jock itch and occurs in the area of the genitalia, usually as the result of perspiration from athletic activities.
The critical care nurse is administering intravenous anidulafungin to a client for the treatment of candidemia. The client’s blood urea nitrogen and creatinine levels have been rising in recent days due to adverse effects of other medications. What is the nurse’s best action?
A) Confirm the drug with the provider.
B) Hold the medication pending the provider’s reassessment of the client.
C) Confirm the route with the provider.
D) Administer the medication as prescribed because it is not excreted renally.
D) Administer the medication as prescribed because it is not excreted renally.
Rationale:Anidulafungin is excreted in the feces, so renal impairment should not have a significant impact on therapy.
The nurse is working with a client who has a cutaneous fungal infection and who has been prescribed a topical antifungal ointment. The client tells the nurse, “I bought a steroid ointment at the drugstore because I read it might help with my skin infection.” What is the nurse’s best response?
A) “Any ointment that you’re able to buy without a prescription likely isn’t going to help much.”
B) “Actually, that ointment would probably make your infection worse, not better.”
C) “You can’t safely take any over-the-counter drugs while you’re taking a prescription drug.”
D) “It’s best to check with your healthcare provider before applying any of the steroid ointment.”
D) “It’s best to check with your healthcare provider before applying any of the steroid ointment.”
Rationale:The client should inform the provider before using any OTC medications. These are not always contraindicated or ineffective, but the client should confirm this with the provider.
A client with a systemic Candida infection has been prescribed flucytosine 100 mg/kg/day PO in divided doses at 6-hour intervals. The client weighs 110 lbs. How many 500-mg tablets should the nurse administer for the client’s first dose?
___________tablets
2.5 tab
Rationale:110 lbs ÷ 2.2 = 50 kg. The client is to receive 100 mg/kg, and 100 mg × 50 kg = 5,000 mg/day. At 6-hour intervals, this yields 1,250 mg per dose. 1,250 mg ÷ 500 mg/tablet = 2.5 tablets
A topical antifungal cream should be gently rubbed into the affected area that has been washed with soap and water and patted dry.
A) FALSE
B) TRUE
B) TRUE
Rationale:The area should be gently cleaned before applying the antifungal cream and then gently rubbed into the affected area. Avoid covering the area to reduce risk of systemic absorption. Clients should be taught to wash their hands after application (unless the cream was applied to the hands).
