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. Chlorpheniramine is a first-generation antihistamine and may cause sedation and other side effects due to its ability to cross the blood-brain barrier.
B. Cetirizine is a second-generation antihistamine that is less likely to cause sedation and is used to relieve symptoms of allergic rhinitis.
C. Montelukast is a leukotriene receptor antagonist, not an antihistamine, and is used for allergic rhinitis and asthma.
D. Diphenhydramine is a first-generation antihistamine known for its sedative effects and is often used for allergies but is not classified as a second-generation antihistamine.
Correct Answer is C
Explanation
A. While liver failure may affect excretion indirectly, it primarily impacts metabolism more significantly.
B. Absorption is typically not directly affected by liver function, though it can be influenced by other factors.
C. The liver is crucial for drug metabolism; chronic liver failure impairs the liver's ability to metabolize medications effectively, leading to potential toxicity.
D. Distribution may be altered due to changes in plasma proteins or blood flow, but the most significant impact occurs in metabolism.