Chapter 11: Antifungal Agents prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

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Chapter 11: Antifungal Agents prepU Question 1 See full question51s Report this Question A client, being treated for a fungal infection, reports being nauseating and requests that the dose be dec... reased or medication changed. Which statement should form the basis of the nurse’s response to the client’s request? You Selected: Antifungal drugs that are effective for this disease without being excessively toxic to human cells are limited. Correct response: Antifungal drugs that are effective for this disease without being excessively toxic to human cells are limited. Explanation: Development of drugs that are effective against fungal cells without being excessively toxic to human cells has been limited because fungal cells are similar to human cells. Most of the available drugs target the fungal cell membrane and produce potentially serious toxicities and drug interactions. In general, antifungal drugs disrupt the structure and function of fungal cell components. This information makes the remaining options incorrect. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Systemic Antifungals, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 2 See full question26s Report this Question The client is receiving ketoconazole. The nurse should be concerned about a drug–drug interaction on the basis of what other comorbidity? You Selected: Type 2 diabetes Correct response: Type 2 diabetes Explanation: Ketoconazole interacts with hypoglycemics, which are given for the treatment of type 2 diabetes. There is no obvious reason why a client’s pain, penicillin allergy or venous ulcer would preclude the safe and effective use of ketoconazole. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 3 See full question47s Report this Question An 80-year-old woman is receiving treatment with oral fluconazole for a fungal infection Following yesterday's and today's dose, she reports an upset stomach to the charge nurse. How should the nurse at the facility best respond to the woman's report? You Selected: Provide food along with the fluconazole when administering it in the future. Correct response: Provide food along with the fluconazole when administering it in the future. Explanation: Fluconazole has the potential to cause gastric distress, a problem that may be mitigated by administering the drug with food. Infusion reactions do not occur with the administration of fluconazole and it is likely unnecessary to arrange for IV administration, to stop the drug, or to immediately inform the resident's physician. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation with Rationale, p. 177. Chapter 11: Antifungal Agents - Page 177 Add a Note Question 4 See full question28s Report this Question A client has been placed on amphotericin B. The nurse caring for this client should administer this medication: You Selected: intravenously. Correct response: intravenously. Explanation: Amphotericin B is no longer administered orally; the most common route of administration is IV though intrathecal administration is used when fungus exists in the CSF. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 5 See full question42s Report this Question Antifungal drugs are available that do not fit into either the azole or echinocandin groups. Which fall into the other group? Select all that apply. You Selected: terbinafine (Lamisil) Correct response: griseofulvin (generic) amphotericin B (Abelcet) flucytosine (Ancobon) nystatin (Mycostatin) Explanation: Antifungal drugs that do not fit into either the azole or echinocandin class include amphotericin B (Abelcet, AmBisome, Amphotec, Fungizone), flucytosine (Ancobon), griseofulvin (generic), and nystatin (Mycostatin, Nilstat). Terbinafine (Lamisil) is in the azole group. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Other Antifungal Agents, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 6 See full question28s Report this Question What serious adverse effect is most associated with amphotericin B? You Selected: Nephrotoxicity Correct response: Nephrotoxicity Explanation: Systemic antifungal drugs may cause serious adverse effects. Nephrotoxicity is associated with amphotericin B; hepatotoxicity is associated with azole drugs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Azole Antifungals, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 7 See full question28s Report this Question The azole antifungals are contraindicated in clients with what condition? You Selected: Increased liver enzymes Correct response: Increased liver enzymes Explanation: The azole antifungals are relatively contraindicated in clients with increased liver enzymes, active liver disease, or a history of liver damage from other drugs. They should be given only if expected benefits outweigh risks of liver injury. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Azole Antifungals, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 8 See full question19s Report this Question The nurse is caring for several clients who have fungal infections. Which client should the nurse prioritize for informing the provider? You Selected: A client receiving amphotericin B whose torso appears jaundiced Correct response: A client receiving amphotericin B whose torso appears jaundiced Explanation: A new onset of jaundice suggests hepatotoxicity related to amphotericin B. This is a significant and time- dependent finding that must be addressed quickly. This would be prioritized over a client's need for medication education. A rash related to topical antifungal use is suggestive of local irritation, not a generalized hypersensitivity reaction. Administration of a vaginal suppository would not take precedence over a client's new onset of hepatotoxicity. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Adverse Effects, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 9 See full question36s Report this Question A parent has informed the nurse that she has been applying an over the counter antifungal to her infant’s buttocks and perineal region for a rash. What question related to safety should the nurse ask the parent? You Selected: “Are there any open wounds on the areas where you’re putting the ointment?” Correct response: “Are there any open wounds on the areas where you’re putting the ointment?” Explanation: Topical agents should not be used over open or draining areas that would increase the risk of systemic absorption and toxicity. Allergy status is always important, but questions of applying the medication over open areas would be a safety priority; no aspect of the scenario suggests a hypersensitivity response. Previous use of herbal remedies may be relevant but is not a high priority. The mother’s use of antifungals while pregnant is not relevant. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Table 11.2 Drugs in Focus: Topical Antifungals, p. 178. Chapter 11: Antifungal Agents - Page 178 Add a Note Question 10 See full question33s Report this Question An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom? You Selected: jaundice Correct response: jaundice Explanation: The azoles may cause hepatotoxicity, and the development of jaundice usually accompanies liver damage, which may necessitate discontinuing the drug. Fluconazole is not associated with weight gain, anemia, or hematuria. Question 1 See full question19s Report this Question A client with topical mycosis was prescribed oxiconazole for topical administration and has been using the medication for 10 days. The client now reports an open wound on the same region. What is the nurse's best action? You Selected: Tell the client not to administer the medication and to come be assessed by the provider Correct response: Tell the client not to administer the medication and to come be assessed by the provider Explanation: Topical antifungals should not be applied over open or broken skin, so the nurse should encourage the client to see the provider for a change in treatment. Because of the safety risk associated with putting the medication on open skin the nurse is justified in having the client temporarily withhold the medication pending assessment by the provider. Applying barrier cream would defeat the purpose of the medication. Applying a bandage is insufficient and infection is not the most important risk. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Table 11.2 Drugs in Focus: Topical Antifungals, p. 178. Chapter 11: Antifungal Agents - Page 178 Add a Note Question 2 See full question19s Report this Question A client is being treated for histoplasmosis with amphotericin B. The nurse has completed a comprehensive assessment of the client and should report what assessment finding? You Selected: The client's urine output is 75 mL over six hours Correct response: The client's urine output is 75 mL over six hours Explanation: Decreased urine output could be suggestive of renal damage, which must be addressed immediately. Diarrhea, headache and lack of appetite should be addressed by the nurse but are lower priorities. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Table 11.1 Drugs in Focus: Systemic Antifungals, p. 172. Chapter 11: Antifungal Agents - Page 172 Add a Note Question 3 See full question22s Report this Question A client has been prescribed a topical antifungal ointment to treat a fungal infection between her breasts. When providing education about this medication, the nurse should encourage the client to: You Selected: wash and dry the affected area before applying the ointment. Correct response: wash and dry the affected area before applying the ointment. Explanation: Clients should be instructed to wash and dry affected areas before applying antifungal ointments. Soap is not prohibited and there is no reason to avoid sunlight. The frequency of administration varies, but there is no topical antifungal that can be safely used every two hours. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Assessment: History and Examination, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 4 See full question27s Report this Question A client has been diagnosed with a fungal infection and been prescribed a topical antifungal medication. What assessment question should the nurse ask when addressing the possible etiology of the fungal infection? You Selected: “Have you been prescribed any antibiotics in the recent past?” Correct response: “Have you been prescribed any antibiotics in the recent past?” Explanation: A course of antibiotics can often precipitate a fungal infection. Hospital visits, immunizations and a history of acne are not identified as risk factors or causes of fungal infections. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Assessment: History and Examination, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 5 See full question3m 9s Report this Question A nurse is caring for a client who is recceiving fluconazole. Which statement by the nurse should be used in the teaching plan for the medication? You Selected: “It decreases the localized yeast production.” Correct response: “It decreases the localized yeast production.” Explanation: Fluconazole is an azole, a group of commonly used antifungal agents. Fluconazole binds to sterols in the fungal cell member reducing the localized yeast production. Fluconazole is an antifungal and does not assist with bacterial invasions or shorten inflammatory pain and the length of the process. Fluconazole is a strong inhibitor of CYP2CP enzymes. Question 1 See full question47s Report this Question A client is receiving gentian violet as topical treatment for a fungal infection. What instruction should the nurse include in the teaching plan? You Selected: "This medication can stain your skin and clothing." Correct response: "This medication can stain your skin and clothing." Explanation: Gentian violet stains the skin and clothing bright purple. Occlusive dressings should be avoided to prevent systemic absorption; gentian violet is very toxic when absorbed. Gentian violet should not be applied to open lesions. It is topical, not oral. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 2 See full question6s Report this Question Ketoconazole is available in oral form, a shampoo, and a cream. You Selected: True Correct response: True Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 3 See full question30s Report this Question A client develops itching and burning of the vaginal vault while taking an anti-infective to treat strep throat. What fungal agent has caused the burning and itching? You Selected: Candida albicans Correct response: Candida albicans Explanation: Growth of Candidaorganisms is normally restrained by intact immune mechanisms and bacterial competition of nutrients. When these restraining forces are altered (antibacterial drug therapy), fungal overgrowth and opportunistic infection can occur. Cryptococcus neoformans organisms evade normal immune defense of phagocytosis. Aspergillus organisms produce protease. Dermophyte grow on cool body surfaces. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Chapter 11, Contraindications and Cautions, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 4 See full question29s Report this Question A nurse is instructing a 19-year-old female patient on the use of fluconazole for candida vaginitis. A teaching priority will be to: You Selected: use an alternative form of birth control, if taking an oral contraceptive. Correct response: use an alternative form of birth control, if taking an oral contraceptive. Explanation: A teaching priority would be to tell the client to use another form of birth control if she was taking an oral contraceptive. Fluconazole may decrease the effectiveness of oral contraceptives. Taking an antiemetic or antidiarrheal for adverse GI effects would be an appropriate instruction for this drug. The nurse should also instruct the client to take aspirin instead of acetaminophen for relief of minor discomforts because acetaminophen has the potential to damage the liver and kidneys. Taking the drug with food is recommended if the client experiences GI distress. All of these instructions are important, but not as important as making sure that the client does not inadvertently become pregnant while on the medication. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 5 See full question38s Report this Question Which statement would be correct for a client regarding the administration of an antifungal medication? You Selected: Instruct the client to complete the entire drug therapy even if a dose is missed. Correct response: Instruct the client to complete the entire drug therapy even if a dose is missed. Explanation: Any client who is prescribed an antiviral or an antifungal drug needs to be advised to complete the entire drug therapy religiously and not to miss any drug dose. However, he or she need not take the missed dose if it is already time for the next dose. Clients should be informed that they should seek the advice of the prescriber if they experience any adverse effects such as redness, headache, swelling, or an aggravated lesion on the body. Clients should be advised to remain well hydrated throughout the therapy and not take heavy, fatty meals if they suffer from GI distress. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation with Rationale, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 6 See full question27s Report this Question A nurse is caring for a client who asks why she has been prescribed posaconazole following kidney transplantation. The nurse responds that posaconazole is used as prophylaxis to prevent: You Selected: Aspergillus infection. Correct response: Aspergillus infection. Explanation: Posaconazole is an azole with activity against Candida and Aspergillus infections. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Fluconazole, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 7 See full question55s Report this Question The pediatric nurse is caring for a client with aspergillosis. The client weighs 66 pounds has been prescribed voriconazole 6 mg/kg IV q12h for two doses. How many mg of the medication should the nurse administer for each dose? Your Response: 180 Correct response: 180 Explanation: The client's weight must first be converted to kilograms by dividing by 2.2. This yields a weight of 30 kg. The prescribed dose is 6 mg/kg, and 6 mg x 30 kg = 180 mg. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, pp. 171 - 172. Chapter 11: Antifungal Agents - Page 171 - 172 Add a Note Question 8 See full question37s Report this Question The nurse is caring for a client diagnosed with a life-threatening systemic fungal infection that is not responding to treatment with an azole. What medication should the nurse anticipate the provider may order next? You Selected: Amphotericin B Correct response: Amphotericin B Explanation: Amphotericin B is a potent drug with many serious adverse effects so it is often used only when other medications are not effective. Nystatin and butenafine are topical agents and would not be used for a systemic infection. Terbinafine is an azole and would not be used if azoles do not work. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Clinically Important Drug–Drug Interactions, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 9 See full question25s Report this Question An adult client, recently diagnosed with a tinea infection, has begun treatment with griseofulvin. During a scheduled clinic visit, the client states to the nurse, “I'm pretty good at reading my body's signals, so I make sure to take a bit extra when I think my infection is getting worse.” This client's statement is suggestive of what nursing diagnosis? You Selected: deficient knowledge related to correct use of griseofulvin Correct response: deficient knowledge related to correct use of griseofulvin Explanation: In order to achieve maximum therapeutic benefit, it is important for the client to take the drug exactly as prescribed. The client's statement suggests that the client does not appreciate or understand this fact. There is no evidence of pathological thought patterns or ineffective coping. The statement reflects an inaccurate conclusion regarding the symptom management of this disorder. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Adverse Effects, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 10 See full question29s Report this Question What information should the nurse provide a client prescribed warfarin and fluconazole concurrently? You Selected: The client will require regular assessment of the fluconazole toxicity. Correct response: The client will require regular assessment of the fluconazole toxicity. Explanation: Fluconazole is a strong inhibitor of CYP2C9 enzymes, and concurrent administration of losartan, phenytoin, or warfarin results in greater risk of toxicity with the inhibited drugs. The remaining statements are inaccurate. Question 1 See full question18s Report this Question A client with a systemic fungal infection has been prescribed ketoconazole 350 mg PO daily. What assessment should the nurse prioritize before administration? You Selected: Review of liver enzyme levels Correct response: Review of liver enzyme levels Explanation: Ketoconazole has been associated with severe hepatic toxicity and should be avoided in clients with hepatic dysfunction to prevent serious hepatic toxicity. For this reason, liver function would likely be a priority over cranial nerve function and electrolytes. Excretion is renal, so kidney function should be confirmed, but the consequence of hepatic impairment are even more serious. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 2 See full question9s Report this Question A parent has informed the nurse that she has been applying an OTC antifungal to her infant’s buttocks and perineal region. What question related to safety should the nurse ask the parent? You Selected: “Are there any open wounds on the areas where you’re putting the ointment?” Correct response: “Are there any open wounds on the areas where you’re putting the ointment?” Explanation: Topical agents should not be used over open or draining areas that would increase the risk of systemic absorption and toxicity. Allergy status is always important, but questions of applying the medication over open areas would be a safety priority; no aspect of the scenario suggests a hypersensitivity response. Previous use of herbal remedies may be relevant but is not a high priority. The mother’s use of antifungals while pregnant is not relevant. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Key Points, p. 182. Chapter 11: Antifungal Agents - Page 182 Add a Note Question 3 See full question24s Report this Question A topical antifungal cream should be gently rubbed into the affected area that has been washed with soap and water and patted dry. You Selected: True Correct response: True Explanation: The area should be gently cleaned before applying the antifungal cream and then gently rubbed into the affected area. Avoid covering the area to reduce risk of systemic absorption. Clients should be taught to wash their hands after application (unless the cream was applied to the hands). Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation with Rationale, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 4 See full question43s Report this Question An immunocompromised client with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by its influence on: You Selected: the permeability of fungal cell walls. Correct response: the permeability of fungal cell walls. Explanation: Amphotericin B works by binding to sterols in fungal cell membranes. This binding appears to form pores or channels and results in increased cell permeability, cell leakage, and death. The drug does not influence human immune function, fungal reproduction, or the osmolarity within fungal cells. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 5 See full question40s Report this Question Which nursing diagnosis would be most appropriate for a client being treated with an antifungal? You Selected: Acute pain related to GI, CNS, and local effects of the drug Correct response: Acute pain related to GI, CNS, and local effects of the drug Explanation: Acute pain related to GI, CNS, and local effects of the drug would be the best nursing diagnosis in this scenario. Adverse reactions from this drug do not include sleep disturbances or impaired skin integrity. Most antifungals are not long term in their administration. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Nursing Diagnoses, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 6 See full question31s Report this Question A nurse is caring for a client who is receiving amphotericin B. Which medication could the nurse administer concomitantly to promote client comfort? You Selected: antipyretics Correct response: antipyretics Explanation: Amphotericin B is a highly toxic drug with adverse effects than include fever, chills, anorexia, nausea, and vomiting. Antipyretics and antiemetics may be given to reduce these effects and improve client comfort. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation with Rationale, p. 177. Chapter 11: Antifungal Agents - Page 177 Add a Note Question 7 See full question5s Report this Question Laboratory monitoring for clients on all systemic antifungal drugs should include what test? You Selected: LFTs (liver function tests) Correct response: LFTs (liver function tests) Explanation: Liver function should be monitored with all systemic antifungal drugs; both hepatic and renal function should be monitored with amphotericin B. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Adverse Effects:, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 8 See full question45s Report this Question When describing the action of ketoconazole, what would be most accurate? You Selected: It blocks sterol activity of the fungal cell wall. Correct response: It blocks sterol activity of the fungal cell wall. Explanation: Ketoconazole blocks the activity of a sterol in the fungal wall. Posaconazole and voriconazole inhibit the synthesis of ergosterol, which in turn leads to an inability of the fungus to form a cell wall, resulting in cell death. Terbinafine inhibits a CYP2D6 enzyme system, which may make it a better choice for clients who need to take drugs metabolized by the CYP450 system; it also inhibits the formation of ergosterol. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 9 See full question26s Report this Question Which antifungal agent is available for systemic and topical use? You Selected: Ketoconazole Correct response: Ketoconazole Explanation: Ketoconazole can be used systemically and topically to treat fungal infections. Butoconazole and clotrimazole are for topical use only. Voriconazole is for systemic use only. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 10 See full question33s Report this Question What would be most important for the nurse to monitor in a client receiving amphotericin B? You Selected: complete blood count Correct response: complete blood count Explanation: Amphotericin B is associated with bone marrow suppression, so it would be especially important for the nurse to monitor the client’s complete blood count for changes. The drug does not affect coagulation. Although the drug can cause gastrointestinal (GI) irritation with nausea, vomiting, and potentially severe diarrhea, monitoring bowel sounds would not be as important as monitoring the blood count. Amphotericin B does not affect respiratory function. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Clinically Important Drug–Drug Interactions, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 11 See full question1m 1s Report this Question A client is receiving itraconazole. Which drugs should be avoided? (Select all that apply.) You Selected: pimozide simvastatin midazolam Correct response: simvastatin midazolam pimozide Explanation: Itraconazole has a black box warning regarding the potential for serious cardiovascular effects if it is given with simvastatin, midazolam, pimozide, lovastatin, triazolam, or dofetilide. Increased serum level of warfarin, digoxin, and cyclosporine occur when they are administered with ketoconazole due to the drug’s strong inhibition of the cytochrome P450 enzyme system. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Clinically Important Drug–Drug Interactions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 12 See full question16s Report this Question The nurse is providing care for a diverse group of clients. Which client should the nurse monitor most closely for signs and symptoms of a fungal infection? You Selected: A client who is receiving combination therapy for acquired immunodeficiency syndrome (AIDS) Correct response: A client who is receiving combination therapy for acquired immunodeficiency syndrome (AIDS) Explanation: Clients who are immunosuppressed, such as those who have AIDS, are at particular risk for fungal infections. Many older adults also have high risks, but the risk among clients with AIDS is known to be particularly high. Post-operative clients and those with renal failure are not particularly high-risk. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 13 See full question42s Report this Question An older adult client has been diagnosed with candidiasis and prescribed fluconazole. What aspect of the client's health status should warrant close monitoring by the nurse? You Selected: The client has atrial fibrillation and takes warfarin daily Correct response: The client has atrial fibrillation and takes warfarin daily Explanation: Fluconazole causes increased levels of warfarin which may constitute a risk for hemorrhage. The client' use of levothyroxine is not problematic, nor is the fact that the client is a vegetarian and has a low body mass index. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, pp. 171 -173. Chapter 11: Antifungal Agents - Page 171 -173 Add a Note Question 14 See full question43s Report this Question The critical care nurse is caring for a client whose systemic fungal infection is being treated with amphotericin B. The nurse's review of the client's most recent laboratory results indicates a white cell count of 2050/µL (2.05 ×109/L). What is the nurse's best action? You Selected: Report the client's possible bone marrow suppression to the client's provider Correct response: Report the client's possible bone marrow suppression to the client's provider Explanation: A decrease in white cell counts is highly suggestive of bone marrow suppression. Standard precautions should be implemented for all clients, not introduced when client's display an increased risk for infection. A negative pressure isolation room would not protect the client from microorganisms from the environment (unlike a positive pressure isolation room). Immune system stimulants are not the most common response to drug-related bone marrow suppression. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 15 See full question19s Report this Question A client with a fungal infection has been prescribed ketoconazole 250 mg PO daily. The client reports nausea and anorexia the day after starting the medication. What is the nurse's best action? You Selected: Encourage the client to try eating small, frequent meals rather than three larger meals Correct response: Encourage the client to try eating small, frequent meals rather than three larger meals Explanation: Clients who experience GI effects of antifungals may benefit from smaller, more frequent meals. There is no clear need to have the client discontinue or withhold the medication, though the nurse should follow up with the client. Changes in diet should normally be trialed before seeking prescription antiemetics. There is no guarantee that adverse effects will resolve spontaneously. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 16 See full question47s Report this Question A client has been prescribed sulconazole for the treatment of tinea pedis. When nursing diagnosis should the nurse identify when planning this client's care? You Selected: Risk for impaired skin integrity related to local irritation Correct response: Risk for impaired skin integrity related to local irritation Explanation: Sulconazole is a topical antifungal. As such, there is no significant risk for liver or kidney damage. The drug does not cause CNS depression, though there is a possibility of localized skin irritation where it is applied. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 179. Chapter 11: Antifungal Agents - Page 179 Add a Note Question 17 See full question10s Report this Question The client is receiving ketoconazole. The nurse should be concerned about a drug–drug interaction on the basis of what other co-morbidity? You Selected: Type 2 diabetes Correct response: Type 2 diabetes Explanation: Ketoconazole interacts with hypoglycemics, which are given for the treatment of type 2 diabetes. There is no obvious reason why a client’s pain, penicillin allergy or venous ulcer would preclude the safe and effective use of ketoconazole. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 18 See full question36s Report this Question The nurse is caring for a client who has been prescribed micafungin, 150 mg IV daily. What assessment should the nurse prioritize in this client’s care? You Selected: Inspection of the client’s mouth and throat Correct response: Inspection of the client’s mouth and throat Explanation: Micofungin is used in the treatment of clients with esophageal candidiasis. Consequently, the nurse should assess the mucous membranes of the client’s mouth and throat. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 19 See full question27s Report this Question When assessing for potential signs and symptoms of cryptococcosis, the nurse should prioritize what assessment? You Selected: neurological assessment Correct response: neurological assessment Explanation: Cryptococcosis may involve the lungs, skin, and other body organs. In clients with AIDS or other immunosuppressant disorders, it often involves the CNS and produces mental status changes, headache, dizziness, and neck stiffness. Neurological assessment is consequently a priority. All the suggested assessments are appropriate, but none are as relevant as the neurological assessment when considering the signs of cryptococcosis. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents. Add a Note Question 20 See full question31s Report this Question Caspofungin has been prescribed for a client diagnosed with invasive aspergillosis. The nurse should teach the client to promptly report what symptom associated with an adverse reaction? You Selected: cardiac distress Correct response: cardiac distress Explanation: Caspofungin is administered in the acute care setting. The client should receive instruction about the histamine reaction to the medication and the necessity of reporting any cardiac symptoms. Diaphoresis, dry mouth, and muscle pain are not normally associated with the administration of caspofungin. Question 1 See full question16s Report this Question The client is receiving ketoconazole. The nurse should be concerned about a drug–drug interaction on the basis of what other comorbidity? You Selected: Type 2 diabetes Correct response: Type 2 diabetes Explanation: Ketoconazole interacts with hypoglycemics, which are given for the treatment of type 2 diabetes. There is no obvious reason why a client’s pain, penicillin allergy or venous ulcer would preclude the safe and effective use of ketoconazole. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 2 See full question32s Report this Question A nurse is caring for a 29-year-old man who is being treated for meningitis. He is receiving flucytosine (5- FC). Which will the nurse monitor weekly? You Selected: Hematologic status Correct response: Hematologic status Explanation: Flucytosine is toxic to rapidly proliferating tissues, such as the bone marrow and the lining of the GI tract. Therefore, common hematologic adverse effects include anemia, leukopenia, and thrombocytopenia. The nurse will also monitor renal and hepatic status. Abnormal blood pressure, visual impairment, and changes in blood glucose levels are not identified adverse effects of flucytosine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 3 See full question28s Report this Question A client has been placed on amphotericin B. The nurse caring for this client should administer this medication: You Selected: intravenously. Correct response: intravenously. Explanation: Amphotericin B is no longer administered orally; the most common route of administration is IV though intrathecal administration is used when fungus exists in the CSF. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 4 See full question1m 21s Report this Question Fluconazole is the prototype for antifungals. Which are characteristics of fluconazole? (Select all that apply.) You Selected: Treatment of oropharyngeal, esophageal, and vaginal candidiasis Metabolized in the liver and excreted in the urine Binds to sterols in the fungal cell membrane Correct response: Treatment of oropharyngeal, esophageal, and vaginal candidiasis Binds to sterols in the fungal cell membrane Metabolized in the liver and excreted in the urine Explanation: Indications include treatment of oropharyngeal, esophageal, and vaginal candidiasis; cryptococcal meningitis; systemic fungal infections; and prophylaxis to decrease the incidence of candidiasis in bone marrow transplants. The drug binds to sterols in the fungal cell membrane, changing membrane permeability, and is fungicidal or fungistatic, depending on the concentration of the drug and the organism. Regarding the other answer, Interferon Alfa-2b treats malignant melanoma. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 5 See full question6s Report this Question What serious adverse effect is most associated with amphotericin B? You Selected: Nephrotoxicity Correct response: Nephrotoxicity Explanation: Systemic antifungal drugs may cause serious adverse effects. Nephrotoxicity is associated with amphotericin B; hepatotoxicity is associated with azole drugs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Azole Antifungals, p. 176. Chapter 11: Antifungal Agents - Page 176 Add a Note Question 6 See full question25s Report this Question The nurse is caring for a client whose fungal infection is being treated with ketoconazole. What change in the client's health status should the nurse prioritize when updating the provider on the client's condition? You Selected: The client's aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are elevated Correct response: The client's aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are elevated Explanation: An increase in AST and ALT could signal hepatotoxicity, which is a significant adverse effect of ketoconazole. The client's electrolyte levels are within norms and the nurse can normally manage a single episode of vomiting independently. The client's temperature is nominally elevated, so liver enzymes would be a clear priority. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 7 See full question1m 5s Report this Question A student has presented to the campus medical clinic reporting signs and symptoms that suggest vaginal candidiasis. What assessment question should the nurse prioritize when assessing the safety and effectiveness of drug therapy? You Selected: "Is there any possibility that you could be pregnant?" Correct response: "Is there any possibility that you could be pregnant?" Explanation: Pregnancy would have a major bearing on the plan of drug therapy because most antifungals are either contraindicated or require cautious use during pregnancy. Consequently, this assessment question would be prioritized over each of the others, even though it is necessary to ask about previous illnesses, nutritional status and allergies. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Usual Indications, p. 173. Chapter 11: Antifungal Agents - Page 173 Add a Note Question 8 See full question37s Report this Question A client with a fungal infection has been prescribed a miconazole vaginal suppository. What education should the nurse provide about safe and effective administration? You Selected: "If possible, lie down for 10 or 15 minutes after inserting the medication." Correct response: "If possible, lie down for 10 or 15 minutes after inserting the medication." Explanation: Vaginal suppositories should be inserted high in the vagina, with the client lying recumbent after administration. Douching is not recommended and there is no reason to avoid bathing. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Table 11.2 Drugs in Focus: Topical Antifungals, p. 178. Chapter 11: Antifungal Agents - Page 178 Add a Note Question 9 See full question11s Report this Question An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom? You Selected: jaundice Correct response: jaundice Explanation: The azoles may cause hepatotoxicity, and the development of jaundice usually accompanies liver damage, which may necessitate discontinuing the drug. Fluconazole is not associated with weight gain, anemia, or hematuria. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 10 See full question4m 34s Report this Question Which are correct statements regarding amphotericin B deoxycholate administration that a nurse should teach a client? Select all that apply. You Selected: “It works by disrupting fungal cell walls.” “It can be used for progressive or fatal infections." “Hypokalemia and hyponatremia can occur with this medication.” Correct response: “It can be used for progressive or fatal infections." “Hypokalemia and hyponatremia can occur with this medication.” Explanation: Amphotericin B is a polyene and must be given intravenously for systemic fungal infections. It works by binding to ergosterol and forms holes in the membrane, causing leakage of fungal cell contents and lysis of the cell. Echnocandins disrupt fungal cell walls rather than fungal cell membranes. The black box warning from the FDA supports the use of amphotericin B medication with progressive or fatal infections. It should be used cautiously with children and lactating females with life-threatening situations. Hypokalemia and hyponatremia can occur and should be monitored by the nurse prior to administration of the parental medication. Question 1 See full question10s Report this Question A client has a history of deep vein thrombosis, for which he is taking warfarin. When providing education for this client, who is now also taking fluconazole to treat a localized candidal infection, the nurse should instruct the client that: You Selected: Fluconazole increases the effects of warfarin. Have routine lab tests done. Correct response: Fluconazole increases the effects of warfarin. Have routine lab tests done. Explanation: Fluconazole increases the effects of several drugs, including cyclosporine, phenytoin, oral sulfonylureas, and warfarin, but has fewer interactions than ketoconazole and itraconazole. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Azole Antifungals, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 2 See full question33s Report this Question A client is being treated with caspofungin for a systemic fungal infection related to Aspergillus. Prior to the administration of the first parenteral dose, the nurse notes that the client's serum hepatic levels are elevated. How will these serum hepatic enzymes affect the administration of caspofungin? You Selected: The dose will need to be decreased. Correct response: The dose will need to be decreased. Explanation: The dose of caspofungin will need to be reduced due to the risk of hepatotoxicity. The dose of caspofungin should not be increased. The peak and trough is not as vital as the reduction of the dose. The medication should be administered at a lower dose. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 3 See full question42s Report this Question The nurse is caring for a client receiving amphotericin B. Which condition should the nurse assess for in this client? You Selected: phlebitis Correct response: phlebitis Explanation: Amphotericin B and flucytosine are available in IV form. During intravenous administration, there could be pain at the injection site with the possibility of phlebitis or thrombophlebitis. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation with Rationale, p. 177. Chapter 11: Antifungal Agents - Page 177 Add a Note Question 4 See full question33s Report this Question Guidelines for the use of topical antifungals in children are frequently the same as those for adults. However, safety and dosage recommendations have not been established for most oral and IV antifungals in the pediatric population. Which antifungal drug is suitable for pediatric use? You Selected: fluconazole Correct response: fluconazole Explanation: Fluconazole is suitable for use in children. Safety and effectiveness have not been established for caspofungin in children; safety and effectiveness have not been established for voriconazole in children under twelve years of age. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 5 See full question48s Report this Question An adult client who is critically ill with histoplasmosis has been prescribed amphotericin B 60 mg PO daily. What aspect of this order should the nurse discuss with the prescriber? You Selected: The route Correct response: The route Explanation: Amphotericin B is only available for intravenous administration. The choice of drug, timing and dose are appropriate. Question 1 See full question13s Report this Question A client, being treated for a fungal infection, reports being nauseating and requests that the dose be decreased or medication changed. Which statement should form the basis of the nurse’s response to the client’s request? You Selected: Antifungal drugs that are effective for this disease without being excessively toxic to human cells are limited. Correct response: Antifungal drugs that are effective for this disease without being excessively toxic to human cells are limited. Explanation: Development of drugs that are effective against fungal cells without being excessively toxic to human cells has been limited because fungal cells are similar to human cells. Most of the available drugs target the fungal cell membrane and produce potentially serious toxicities and drug interactions. In general, antifungal drugs disrupt the structure and function of fungal cell components. This information makes the remaining options incorrect. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Systemic Antifungals, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 2 See full question44s Report this Question A client is undergoing treatment with amphotericin B. The client feels like a medication reaction is taking place about 1 hour into the infusion and reports fevers and chills. The nurse should: You Selected: inform the client that the client is allergic to amphotericin B and stop the infusion. Correct response: inform the client that this is a common reaction. Obtain orders to treat the client's fever and provide comfort measures for the chills. Explanation: Adverse effects with administration of amphotericin B include an infusion reaction (eg, fever, chills, tachypnea). Nephrotoxicity is the most common and the most serious long-term adverse effect. Hypokalemia and hypomagnesemia also occur and may require oral or IV mineral replacement. Additional adverse effects include anorexia, nausea, vomiting, anemia, and phlebitis at peripheral infusion sites. A central vein is preferred for administration. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Therapeutic Actions and Indications, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 3 See full question17s Report this Question Incidence of fungal infections has increased with the rising number of people who are immunocompromised. What groups are considered to have a compromised immune system? (Select all that apply.) You Selected: Clients with acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) The elderly Clients taking immunosuppressant drugs Clients who have undergone transplantation surgery or cancer treatment Correct response: Clients with acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) Clients taking immunosuppressant drugs Clients who have undergone transplantation surgery or cancer treatment The elderly Explanation: The incidence of fungal infections has increased with the rising number of people who are immunocompromised. This group includes clients with acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC), those taking immunosuppressant drugs, those who have undergone transplantation surgery or cancer treatment, and members of the increasingly large elderly population, whose bodies are no longer able to protect against the many fungi found throughout the environment. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Antifungal Agents, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 4 See full question3m 17s Report this Question A 42-year-old woman with a systemic fungal infection is admitted to the hospital. The nurse practitioner prescribes ketoconazole. The nurse preparing to administer this medication understands that azole antifungals require caution under certain conditions. To which patient would the nurse be especially cautious about administering this drug? Select all that apply. You Selected: client with hepatic dysfunction a pregnant woman with a history of headaches Correct response: client with hepatic dysfunction a pregnant woman with a history of headaches Explanation: Many of the azoles are associated with liver toxicity and can cause severe effects on a fetus or nursing baby. All other choices are not applicable. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Contraindications and Cautions, p. 174. Chapter 11: Antifungal Agents - Page 174 Add a Note Question 5 See full question5s Report this Question A pharmacology student is learning about amphotericin B. This drug can be administered via which route? You Selected: IV Correct response: IV Explanation: Amphotericin B can be given intravenously. It is not administered via the subcutaneous or intramuscular routes. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Pharmacokinetics, p. 175. Chapter 11: Antifungal Agents - Page 175 Add a Note Question 6 See full question16s Report this Question The nurse at a long-term care facility is admitting a new resident who is an older adult. The resident's current medication regimen includes nystatin 1,000,000 units PO t.i.d. The nurse should recognize the need to prioritize what aspect of this resident's care? You Selected: Mouth care Correct response: Mouth care Explanation: Nystatin PO is normally prescribed for oral candidiasis. Fluid intake would not have an immediate effect on the resident's health problem and there is no indication for protective isolation. There is no reason to believe the client has a fungal scalp infection. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Implementation, p. 181. Chapter 11: Antifungal Agents - Page 181 Add a Note Question 7 See full question46s Report this Question The nurse is teaching peers about fungal infections and describes the cell membrane of a fungal cell how? You Selected: Contains ergosterol Correct response: Contains ergosterol Explanation: Ergosterol is a steroid-type protein found in the cell membrane of fungi; similar in configuration to adrenal hormones and testosterone. Fungi have a hard cell wall. The cell membrane contains polysaccharides. Mycosis is a disease caused by a fungus. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents. Add a Note Question 8 See full question43s Report this Question When administering the azoles in the home setting, the home health nurse should prioritize educational interventions that address what nursing diagnosis? You Selected: Risk for infection related to antifungal therapy Correct response: Risk for infection related to antifungal therapy Explanation: When administering the azoles in the home setting, it is important that the home care nurse instruct the client and family on the management of the environment with the implementation of good hand hygiene, household cleanliness, removal of potted plants and fresh flowers, and the use of air conditioning and air filtration systems. The nurse should also tell the client and family about measures to prevent the reinfection and spread of the fungal infection. Falls, confusion, and injury are less likely consequences of using the azoles in the home setting. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Azole Antifungals, p. 171. Chapter 11: Antifungal Agents - Page 171 Add a Note Question 9 See full question1m 54s Report this Question Anidulafungin is prescribed to treat what form of fungal infection? You Selected: candidiasis Correct response: candidiasis Explanation: Anidulafungin is a semisynthetic antifungal medication that inhibits glucan synthase, an essential component in the fungal cell wall. It is used to treat esophageal candidiasis and other Candida infections. Anidulafungin is not prescribed to effectively treat any of the other suggested fungal infections. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 11: Antifungal Agents, Drugs in Focus: Systemic Antifungals, p. 172. Chapter 11: Antifungal Agents - Page 172 Add a Note Question 10 See full question30s Report this Question An older adult resident of a long-term care facility has been diagnosed with a fungal infection and has been prescribed fluconazole. What change in the client’s laboratory values may necessitate a change in medication therapy? You Selected: decreased creatinine clearance Correct response: decreased creatinine clearance Explanation: Fluconazole is routinely administered to older clients with Candida infections. However, it is necessary to monitor the creatinine clearance and hepatic enzymes. Decreased creatinine clearance may indicate hepatotoxicity and thus warrant a change in medication. Fluconazole is not known to affect the client’s hematological status or immune system. [Show More]

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