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 B
Explanation
A. Cherries do not contain tyramine, which is the compound of concern for clients on MAOIs, so they can be included in the diet.
B. Cheddar cheese is high in tyramine, which can lead to hypertensive crises when consumed by clients taking MAOIs. Therefore, it should be eliminated from the diet.
C. Chicken is generally safe for clients on MAOIs as it does not contain significant amounts of tyramine.
D. Fresh fish is also safe to consume while on MAOIs as long as it is fresh and not aged, fermented, or spoiled, which could contain higher tyramine levels.
Correct Answer is C
Explanation
A. Grapefruit juice does not have a known interaction with metronidazole and does not need to be avoided.
B. Dairy does not interfere with metronidazole's absorption or effectiveness, so it is not a contraindication.
C. Alcohol should be strictly avoided during and for at least 48 hours after metronidazole treatment, as it can cause a severe reaction, including nausea, vomiting, flushing, and rapid heart rate.
D. Tyramine-based foods do not interact with metronidazole, so they are not a contraindication for this medication.