A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the suprainfection. What will the nurse do?
a. Administer the erythromycin and the ketoconazole as ordered.
b. Contact the provider to discuss changing to a different antifungal medication.
c. Contact the provider to discuss increasing the dose of erythromycin.
d. Contact the provider to suggest using erythromycin stearate.
ANS: B
Erythromycin can prolong the QT interval when present in large concentrations. When erythromycin is combined with a CYP3A4 inhibitor, such as ketoconazole, the risk of sudden cardiac death increases fivefold. The nurse should discuss changing the antifungal medication to one that is not a CYP3A4 inhibitor. It is not correct to give the ketoconazole without questioning the order. Increasing the dose of erythromycin would increase the risk of QT prolongation. Changing to a different preparation of erythromycin would not alter the risk.
You might also like to view...
A nurse is planning to teach an 80-year-old patient who has exhibited short-term memory loss how to change his dressing. She should:
A) Set long-term goals with the patient. B) Provide some music to aid learning. C) Keep visual cues to a minimum. D) Keep teaching periods short.
Which issue is of concern to nursing?
1. The grand theories of nursing often do not take environment into consideration. 2. The level of theory that drives much research in nursing is generally from other disciplines. 3. The majority of nursing research is guided by grand theories. 4. There are no middle-range nursing theories.
An African-American woman has taken on the responsibility of raising her grandchild. Which intervention will best address a need commonly identified in this specific population?
a. Providing her with a list of local afterschool children's programs b. Suggesting she enroll in a local community center's senior support group c. Scheduling her for a complete physical examination d. Encouraging her to walk 1 mile 3 days a week
The nurse is reviewing the dietary recommendations with a client recovering from an acute episode of diverticular disease. The nurse identifies the following for inclusion in the discussion: Select all that apply
1. Incorporating both soluble and insoluble fiber into the daily diet. 2. Ingesting at least 25 to 30 grams of fiber daily as is recommended for adults. 3. Eating oatmeal-based cereals as breakfast and snack foods. 4. Avoiding eating fresh grapes because the skins can be problematic. 5. Including raisins in the diet as a good source of iron to offset poor iron absorption.