A patient admitted with an infected below-the-knee amputation ...

[cagreen833]

A patient admitted with an infected below-the-knee amputation (BKA) and heart failure (HF) is taking vancomycin (Vancocin) and furosemide (Lasix). Which of the following is the most important instruction the nurse should provide?
 
  a. Report any ringing in the ears or dizziness.
  b. Report frequent nocturia.
  c. Elevate the affected extremity.
  d. Keep the head of the bed at 30 degrees.

Question 2

The nurse is providing discharge instructions to a patient about drug-drug and drug-food interactions. Which of the following statements by the patient indicates a lack of understanding about these medications?
 
  a. I can take my cefotetan (Cefotan) with my warfarin (Coumadin).
  b. I can take ceftriaxone (Rocephin) and spironolactone (Aldactone).
  c. I can take yogurt with active cultures to counteract my vulvocandidiasis.
  d. I can drink soda to enhance the effects of my fluconazole (Diflucan).

[tuwy]

Answer to Question 1

ANS: A
Both vancomycin and furosemide are ototoxic; therefore the patient should be instructed to notify the nurse of any ringing in the ears (tinnitus) and/or dizziness.
Nocturia is expected with administration of furosemide, depending on the time of day the drug is administered.
Elevating the extremity is important, but it is not the most important issue in this case.
Elevating the head of the bed to 30 degrees may be good for a patient with HF, but it is not the most important issue in this case.

Answer to Question 2

ANS: A
Cephalosporins disrupt prothrombin levels by interfering with vitamin K metabolism, and patients taking other anticoagulant medications (eg, warfarin) are especially at risk. This statement indicates a need for further teaching.
Ceftriaxone can be taken with spironolactone; no further teaching is needed.
Yogurt with active cultures has been shown to help eliminate yeast infections in women; no further teaching is needed.
Soda has been shown to enhance the effects of fluconazole; no further teaching is needed.

[cagreen833]

TYSM

[carlsona147]

Gracias!