The nurse is caring for an immunosuppressed pediatric client who reports soreness in his mouth and refuses to eat. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. The nurse should anticipate which drug to be administered to this client?
nystatin (Mycostatin)
amoxicillin (Amoxil)
metronidazole (Flagyl)
acyclovir (Zovirax)
The Correct Answer is A
A. Nystatin is an antifungal medication used to treat oral candidiasis (thrush), which is consistent with the client's symptoms of soreness in the mouth and the presence of a white, milky plaque that does not rub off.
B. Amoxicillin is an antibiotic that treats bacterial infections but would not be effective against fungal infections like oral thrush.
C. Metronidazole is an antibiotic and antiprotozoal medication, which is not appropriate for treating oral candidiasis.
D. Acyclovir is an antiviral medication used to treat infections caused by certain viruses, such as herpes, and is not effective for fungal infections like thrush.
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Correct Answer is A
Explanation
A. Asthma is a contraindication for cholinergic medications because these drugs can cause bronchoconstriction and may exacerbate respiratory conditions. Careful assessment is necessary before administration to ensure safety.
B. Hypertension is not a direct contraindication for cholinergic medications; they may not significantly affect blood pressure in most cases.
C. Alzheimer's disease is not a contraindication for cholinergic medications; in fact, cholinergic agents may be used to improve cognitive function in some patients with dementia.
D. Diarrhea is not a contraindication for cholinergic medications but may indicate excessive cholinergic activity; it should be monitored, but it does not prevent administration.
Correct Answer is C
Explanation
A. While hormonal contraceptives can affect blood pressure, the risk of significant hypertension is less immediate than thromboembolism.
B. Dysfunctional uterine bleeding can occur but is generally not as serious as thromboembolism and may resolve with continued use.
C. Combination birth control pills increase the risk of thromboembolic events, such as deep vein thrombosis (DVT) and pulmonary embolism, making it essential to monitor for signs of these complications.
D. Osteoporosis is a long-term concern but is not an acute effect of combination birth control pills; monitoring for thromboembolism is more critical.