A 69-year-old female responded well to inpatient treatment with a ...

[khang]

A 69-year-old female responded well to inpatient treatment with a third-generation cephalosporin. After being largely symptom free for 48 hours, the woman has developed a fever of 38.6C and an elevated white cell count.
 
  What phenomenon may account for this patient's current clinical presentation? A) The patient may be infected with microorganisms that were resistant to the cephalosporin.
  B) The patient may be experiencing a delayed (type IV) hypersensitivity reaction to the cephalosporin.
  C) The patient may be developing glomerulonephritis secondary to the nephrotoxic cephalosporin.
  D) The cephalosporin may have initially caused leukopenia and made the patient susceptible to secondary infection.

Question 2

An older adult patient has been using levothyroxine (Synthroid) for several years on an outpatient basis. The patient has recently sought care, with complaints that are consistent with hypothyroidism.
 
  To which of the patient's following statements may the nurse attribute the decreased effect of Synthroid? A) I've been using a lot of antacids lately because of my indigestion.
  B) My daughter and I have started the Atkin's diet to try to lose some weight.
  C) Overall, I'd say that I'm under a lot of stress lately.
  D) I've stopped taking aspirin for my arthritis and started using Tylenol.

[srodz]

Answer to Question 1

A
Feedback:
Patients treated with cephalosporins may be vulnerable to superinfections (infection after a previous infection, typically caused by microorganisms that are resistant to the antibiotics used earlier). Delayed hypersensitivity and renal involvement are highly unlikely. Antibiotics do not cause leukopenia.

Answer to Question 2

A
Feedback:
Antacids may decrease the effect of levothyroxine. Acetaminophen, stress, and high protein intake do not have this effect.

[khang]

TY

[srodz]

You're welcome