Page 1899 - Saunders Comprehensive Review For NCLEX-RN

g. Nitrofurantoin may impart a

harmless brown color to the urine.
h. Nitrofurantoin is

contraindicated in clients with renal
impairment.
i. Instruct the client in expected side and
adverse effects, signs warranting
notification of the primary health care
provider (PHCP), and not to take
nitrofurantoin with antacids.
II. Fluoroquinolones (Box 55-2)
A. Description: Suppress bacterial growth by inhibiting an enzyme
necessary for DNA synthesis; active against a broad spectrum of
microbes
B. Side and adverse effects and nursing considerations

1. Can cause dizziness, drowsiness, gastric

distress, diarrhea, vaginitis, nausea, and vomiting
2. Adverse effects include psychoses, hallucinations,
confusion, tremors, hypersensitivity, and interstitial
nephritis.

With fluoroquinolones, there is an increased risk for tendonitis

and tendon rupture. The Achilles tendon is most often involved, but the
shoulder and hand tendons can also be affected. Clients at increased
risk are those over the age of 60 years, those taking corticosteroids, and
clients who have undergone organ transplant.

3. Fluoroquinolones should be used with caution

in clients with hepatic, renal, or central nervous
system (CNS) disorders.
4. Monitor client for side and adverse effects.
5. Ciprofloxacin and ofloxacin may be taken with or
without food.
6. Intravenously administered ciprofloxacin and
ofloxacin are infused slowly over 60 minutes to
minimize discomfort and vein irritation.
7. Advise the client to report dizziness,

lightheadedness, visual disturbances, increased light
sensitivity, and feelings of depression, because these
signs could indicate CNS toxicity.

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