Chloramphenicol, Nursing Diagnosis, and Collaborative Problems - Pharmacology

Patients who take chloramphenicol may also experience rash, fever, and dyspnea. Neonates experience gray syndrome.

Here are the common nursing diagnoses that are related to a patient who is taking chloramphenicol.

  • Fluid volume deficit related to anorexia, nausea, and vomiting
  • Altered protection related to dose-related bone marrow depression
  • Altered bowel elimination (diarrhea)
  • Altered thought processes (confusion, delirium) related to neurotoxic reactions; sensory-perceptual disturbances related to optic neuritis (blurred vision, loss of vision, eye pain); and to peripheral neuritis (tingling, numbness, and burning pain of the hands and feet)

FLUOROQUINOLONES

Fluoroquinolones are a broad spectrum, synthetic antibiotic that stop bacterial growth in bone and joint infections, bronchitis, gastroenteritis, gonorrhea, pneumonia, urinary tract infection, and many others diseases. However, fluoroquinolones should not be prescribed for infants or children.

Chloramphenicol-Nursing-Diagnosis--Collaborative-Problems

Make sure that the patient doesn’t have an allergic reaction to any fluoroquinolone. If they are allergic to one drug within the fluoroquinolone family, then they are highly likely to be allergic to other fluoroquinolone medications.

Patients who take fluoroquinolones can, in rare cases, experience dizziness, drowsiness, restlessness, stomach distress, diarrhea, nausea and vomiting, psychosis, confusion, hallucinations, tremors, hypersensitivity, and interstitial nephritis (kidney).

The dose of fluoroquinolones should be lowered in patients with hepatic (liver) or renal (kidney) problems. Carefully monitor the serum level of fluoroquinolones for patients who have CNS disorders such as cerebral arteriosclerosis (hardening of the arteries in the brain), epilepsy (seizures), or alcoholism because they are at risk for CNS toxicity. Administer fluoroquinolones with a full glass of water to minimize the possibility of crystalluria. Fluoroquinolones should be infused slowly. Ofloxacin, a member of the fluoroquinolones family, must be infused into a large vein over 60 minutes to minimize discomfort and venous irritation.

After administering fluoroquinolones, monitor the patient’s urinary output. The patient should void at least 1200 to 1500 mL daily. Also monitor the pH of the urine; it should remain at 7.0 or less.

The patient should be provided with the same instructions as those given to a patient who is receiving penicillin (see Penicillin and Patient Education). Tell the patient to report blurry or double vision, sensitivity to light, dizziness, light headedness, or depression. These are signs of CNS toxicity.

If fluoroquinolones are self administered, tell the patient to avoid taking the drug within two hours of taking an antacid. The patient should also avoid exposure to sunlight and sunlamps. The patient must wear sunglasses and avoid bright lights.


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