Final answer:
Vancomycin should be used with caution in patients with renal failure due to the need for renal excretion and potential for drug accumulation and toxicity. Meanwhile, nalidixic acid inhibits DNA gyrase in bacteria, and oliguric phase treatment often involves loop diuretics that inhibit sodium and chloride reabsorption.
Step-by-step explanation:
The nurse should use vancomycin with caution in a patient with renal failure. While drugs like cinacalcet and paricalcitol are used to manage secondary hyperparathyroidism in renal patients, and gemfibrozil is employed to treat high cholesterol, vancomycin is an antibiotic that is excreted by the kidneys. Due to its renal clearance, patients with impaired renal function can have an accumulation of the drug, which can potentially lead to toxicity. Hence, dosing adjustment and careful monitoring of drug levels are crucial in patients with renal insufficiency to avoid adverse effects.
As for antimicrobials, nalidixic acid inhibits the activity of DNA gyrase which is crucial for bacterial DNA replication. It is categorized as a quinolone antibiotic.
The oliguric phase being referred to is typically associated with acute renal failure, where there is minimal urine output. During this phase, the patient is at risk of fluid overload, necessitating medications that act on the loop of Henle to inhibit the reabsorption of sodium and chloride, helping to mitigate fluid retention.