A patient has been taking antibiotics to treat recurrent pneumonia. The patient is in the clinic after having diarrhea for 5 days with six to seven liquid stools each day. The primary care NP should:
a. obtain a stool specimen and order vancomycin.
b. order testing for Clostridium difficile and consider metronidazole therapy.
c. prescribe diphenoxylate (Lomotil) to provide symptomatic relief.
d. reassure the patient that diarrhea is a common side effect of antibiotic therapy.
B
The guidelines for treatment of diarrhea emphasize comprehensive evaluation before treatment begins. Antibiotic use points to C. difficile as a possible cause, and metronidazole is often used to treat mild to moderate infection. Vancomycin is used when C. difficile is severe. Diphenoxylate can worsen the infection because it slows transit time of the bacteria in the gut. Prolonged diarrhea during antibiotic therapy should be investigated.
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A 77-year-old woman who experiences significant anxiety has been taking diazepam for several months
She was brought to the clinical earlier this week by her daughter, who stated that her mother had been behaving in an uncharacteristically confused manner. The clinician discontinued the patient's diazepam. Three days later, the daughter states that her mother has still been having problems with impaired memory and confusion. The nurse should consider what possible explanation for the patient's current status? A) Benzodiazepines can occasionally cause permanent alterations in personality and level of consciousness. B) The patient may have decreased liver function. C) The patient may have been experiencing a hypersensitivity to the drug, rather than an adverse effect. D) The adverse effects of benzodiazepines can persist for several days after stopping the drug.
On examination of a young woman, the nurse notes severe erosion of the teeth, with one tooth missing. The nurse suspects the client has a(n)
a. inadequate intake of calcium c. lack of fluoridated water b. eating disorder d. diet low in protein
A client has recently moved from Vermont to South Florida. The client presents to the clinic reporting “dizzy spells” and weakness. The client tells the nurse that he has been on the same antihypertensive drug for 6 years, with stable blood pressures and no adverse effects. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
Temperature, dryness, or a rash are observations that you could make regarding the ____________________ system.
Fill in the blank(s) with the appropriate word(s).