A child has been receiving chloramphenicol for a Neisseria ...

[nmorano1]

A child has been receiving chloramphenicol for a Neisseria meningitidis central nervous system (CNS) infection.
 
  The nurse administers the dose and subsequently notes that the child has vomited and appears dusky and gray in color. The child's abdomen is distended. What will the nurse do?
  a. Contact the provider for an order to obtain a chloramphenicol level.
  b. Notify the provider that the child's meningitis is worsening.
  c. Recognize this as initial signs of a C. difficile infection.
  d. Stop the infusion immediately and notify the provider.

Question 2

Which side effect of clindamycin (Cleocin) causes the most concern and may warrant discontinuation of the drug?
 
  a. Diarrhea
  b. Headache
  c. Nausea
  d. Vomiting

[Kimmy]

Answer to Question 1

ANS: D
Gray syndrome is a potentially fatal toxicity associated with chloramphenicol use. When symptoms occur, the drug should be stopped immediately. Lower chloramphenicol levels may prevent gray syndrome, but lowering the dose will not stop symptoms once they have appeared. These are not signs of worsening meningitis or a C. difficile infection.

Answer to Question 2

ANS: A
CDAD is a serious, sometimes fatal suprainfection associated with clindamycin. Patients with diarrhea should notify their prescriber immediately and discontinue the drug until this condition has been ruled out. Headache, nausea, and vomiting do not warrant discontinuation of the drug and are not associated with severe side effects.

[nmorano1]

TYSM

[flexer1n1]

Excellent