Antimicrobial Therapy
A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct?
"Even normal flora can develop resistance and transfer this to pathogens."
A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching?
"I should stop taking this drug when my symptoms are gone."
A patient received 500 mg of azithromycin [Zithromax] at 0800 as a first dose. What are the usual amount and time of the second dose of azithromycin?
250 mg at 0800 the next day
A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn?
30 minutes after the IV infusion is complete
A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective?
A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
A patient with high-risk factors for tuberculosis will begin therapy for latent TB with isoniazid and rifampin. The nurse learns that this patient takes oral contraceptives. The nurse will counsel this patient to discuss ____ with her provider.
another birth control method
A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins:
disrupt bacterial cell wall synthesis.
A patient is being treated with amphotericin B [Abelcet] for a systemic fungal infection. After several weeks of therapy, the provider orders flucytosine [Ancobon] in addition to the amphotericin. The nurse understands that the rationale for this combination is that it:
lowers the dose of amphotericin B and reduces toxicity.
A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications?
Acetaminophen
A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the superinfection. What will the nurse do?
Contact the provider to discuss changing to a different antifungal medication.
A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient?
Discontinuing the cephalosporin and beginning metronidazole [Flagyl]
Which superficial mycosis is generally treated with oral antifungal agents?
Tinea capitis
A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?
Uncomplicated lower urinary tract infection treatable with short-course therapy
A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin [Dilantin] for seizures. The nurse will contact the provider to discuss:
monitoring phenytoin levels
A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching?
"I should take this medication with food or milk to improve absorption."
A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response?
"Your child should come to the clinic to have a throat culture done today."
A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do?
Make sure to administer the drugs at different times using different IV tubing.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action?
Select an alternate intravenous site and administer the infusion more slowly.
A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do?
Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.
A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient, the nurse will tell the patient that it will be important to:
drink 8 to 10 glasses of water each day.
