A client has been hospitalized for a severe urinary tract ...

[Bob-Dole]

A client has been hospitalized for a severe urinary tract infection (UTI). Ciprofloxacin IV (Cipro) is prescribed. Two days later, the symptoms have abated, and the client is discharged with a prescription for oral ciprofloxacin (Cipro).
 
  What characteristics of fluoroquinolones allow for this quick discharge from the hospital?
  1. Fluoroquinolones given as IV are very expensive, and must be switched to oral administration as soon as possible to save the client money.
  2. Fluoroquinolones have equal serum drug levels with either IV or oral administration, which allows for a smooth transition from IV to oral therapy.
  3. Fluoroquinolones given as an IV infusion eradicate infection quickly so that the client can be discharged.
  4. Fluoroquinolones are less toxic when given orally.

Question 2

A client who has developed a resistance to levofloxacin (Levaquin) is concerned that getting rid of the infection will be impossible. What is the best response by the nurse to the client?
 
  1. The physician will admit you to the hospital and put you on an IV form of levofloxacin (Levaquin). You will not be resistant to that.
  2. The physician will take you off of the levofloxacin (Levaquin) for a few days and then have you start taking it again. Then it will be effective.
  3. The physician will switch you from levofloxacin (Levaquin) to ciprofloxacin (Cipro).
  4. The physician will switch you to another type of antibacterial to which you haven't developed resistance.

[AmberC1996]

Answer to Question 1

Correct Answer: 2
Global Rationale: The serum levels of oral and IV administration of fluoroquinolones are the same, allowing for a smooth transition from IV to oral therapy. Many drugs are expensive, but this would not be a reason for early discharge from the hospital. Fluoroquinolones are effective against infection, but antibacterials must be given for a course of approximately 10 days. There is no difference in toxicity between IV and PO dosage.

Answer to Question 2

Correct Answer: 4
Rationale 1: Placing the client on IV administration will not change the resistance.
Rationale 2: A drug holiday will not change the resistance factor. It is also unsafe not to treat this client's infection.
Rationale 3: It would not be effective to switch a client from one fluoroquinolone to another fluoroquinolone, because resistance to one usually confers resistance to the others in the same class.
Rationale 4: The physician will switch the client to another class of antibacterial to which the client has not developed resistance.
Global Rationale: The physician will switch the client to another class of antibacterial to which the client has not developed resistance. Placing the client on IV administration will not change the resistance. A drug holiday will not change the resistance factor. It is also unsafe not to treat this client's infection. It would not be effective to switch a client from one fluoroquinolone to another fluoroquinolone, because resistance to one usually confers resistance to the others in the same class.

[Bob-Dole]

Gracias!

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