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Chapter 35: Problem 1

A nurse is caring for a severely immunosuppressed client who is on IV amphotericin B (Fungizone). The nurse understands that this medication is highly toxic to the client. What are three priority nursing assessment areas for clients on this medication?

Short Answer

Expert verified
Monitor kidney function, electrolyte levels, and assess for infusion-related reactions.

Step by step solution

01

- Kidney Function Assessment

One of the main priorities is to assess the client鈥檚 kidney function, as amphotericin B is highly nephrotoxic. Monitor serum creatinine and blood urea nitrogen (BUN) levels regularly. Look for signs of decreased urine output or changes in the color of the urine, which could indicate kidney damage.
02

- Electrolyte Monitoring

Another important area is monitoring the client's electrolyte levels, particularly potassium and magnesium, as amphotericin B can cause electrolyte imbalances. Regularly check blood levels of these electrolytes and look for signs of hypokalemia or hypomagnesemia, such as muscle weakness, cramps, or irregular heartbeats.
03

- Infusion-Related Reactions

Finally, assess for infusion-related reactions, which are common with amphotericin B. Monitor the client for fever, chills, headache, nausea, and vomiting during and after the infusion. Be prepared to manage these symptoms if they occur and consider premedication with antipyretics or antihistamines to reduce the severity of reactions.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Kidney Function Monitoring
When a nurse administers IV amphotericin B, keeping a close eye on the client's kidney function is crucial. This medication can damage the kidneys significantly.
Make sure to:
  • Regularly check the client鈥檚 serum creatinine and blood urea nitrogen (BUN) levels. These blood tests help detect any impaired kidney function.
  • Watch out for decreased urine output. A drop in the amount of urine could be an early sign of kidney issues.
  • Note any changes in urine color. Cloudy or darkly colored urine might indicate kidney damage.
Ensuring these checks can help catch kidney problems early and allow for prompt medical intervention.
Electrolyte Imbalance
IV amphotericin B can mess with a client's electrolyte levels, causing an imbalance. Pay special attention to potassium and magnesium levels.
Here's what you should do:
  • Regularly draw blood to assess potassium and magnesium levels. Low levels of these electrolytes can be harmful.
  • Look for signs of hypokalemia (low potassium) and hypomagnesemia (low magnesium). Symptoms include muscle weakness, cramps, and irregular heartbeats.
Monitoring and correcting electrolyte levels are essential to ensure the client's heart and muscles function properly.
Infusion-Related Reactions
Clients receiving IV amphotericin B often experience infusion-related reactions. These can be quite uncomfortable and sometimes severe.
As a nurse, you should:
  • Stay alert for symptoms during and after the infusion. Common reactions include fever, chills, headache, nausea, and vomiting.
  • Be prepared to manage these reactions. Administer antipyretics (for fever) or antihistamines (for allergic reactions) as needed.
  • Consider pre-medicating to lessen side effects. Giving medication before the infusion can reduce the severity of reactions.
Proactively managing these reactions helps keep the client comfortable and prevents complications.

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