A 65 year-old female was admitted to the hospital two days ago with a medical diagnosis of
community-acquired pneumonia plus significant dehydration. She has now been adequately
rehydrated with PO and IV fluids in addition to beginning a 14-day course of levofloxacin
(Levaquin). Following 2 days of IV levofloxacin, she is ready for discharge home with
instructions to maintain an adequate fluid intake and a prescription for levofloxacin 500 mg PO
every day for 12 more days.
You are preparing for her discharge home and in deciding how to instruct her to take the
levofloxacin, her other health problems and medications must be considered:
GERD: esomeprazole (Nexium) 20 mg each day
sucralfate (Carafate) 2 g suspension (20 mL), 2 times each day
Osteoporosis: alendronate (Fosamax) 70 mg PO once each week
calcium citrate (Citrical) 400 mg once each day; 8 oz milk at two meals
each day
Dyslipidemia: rosuvastatin (Crestor) 20 mg each day
Hypothyroidism: levothyroxine (Synthroid) 75 mcg each day
**Discuss the drug classification represented by each of her medications above, including
levofloxacin: MOA, intended goal in its use for the medical problem involved, common side and
adverse effects, and teaching required for the patient to achieve maximal benefit from the drug.
Finally, discuss the problem posed by several of the above medications in relation to a course of
therapy with levofloxacin. How will you as the nurse teach this 65 year-old to take her
medications over the next 12 days? Be specific with a daily schedule (include a chart for the
patient) and provide rationale for your decisions.


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