Question

Jessica Landry is a 24-year-old Caucasian woman. She is 2 years status post–kidney transplant. Her current medications include prednisone 5 mg every day, Prograf 1 mg twice a day, CellCept 500 mg two capsules twice a day, warfarin 5 mg every day, enalapril 10 mg every day, simvastatin 10 mg every day, Ortho Novum 7/7/7 every day, Advair 250/50 one inhalation twice a day, and Proventil HFA two puffs every 4 to 6 hours as needed for wheezing and shortness of breath. She presents today complaining of irritation and soreness in her mouth and throat.

1. Which of Ms. Landry’s medications or medical conditions put her at risk for a fungal infection?

2. The physician diagnoses Ms. Landry with oral candidiasis and prescribes nystatin suspension 1 teaspoonful four times a day for 7 days. How should the nurse counsel her to use the suspension as part of the nurse’s teaching plan?

3. What adverse effects should the nurse tell Ms. Landry to expect?

Answer 1

1. Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the natural balance of microorganisms in your body can increase your risk of oral thrush. Proventil HFA two puffs every 4 to 6 hours Proventil HFA two puffs every 4 to 6 hours may lead to oral thrush.

2. Swish it around the mouth, gargle, and swallow or spit out as directed. Keep the liquid in your mouth for as long as possible. Then repeat with the remaining half of the dose in the other side of the mouth. Avoid eating for 5-10 minutes after using this medication.

3. Common side effects may include: mouth irritation; upset stomach, nausea, vomiting, diarrhea; or. skin rash.