Module 9- Medications for Infectious Disease (Case Study and Activities)

vancomycin

therapeutic use: methicillin-resistant Staphylococcus aureus (MRSA)

metronidazole

therapeutic use: trichomoniasis

acyclovir

therapeutic use: viral infections

a. Rash

A client is prescribed amoxicillin to treat an ear infection. The health care provider instructs the client to monitor and report which of the following? a. Rash b. Blurred vision c. Peripheral edema d. Insomnia

d. Tinnitus

A client is prescribed gentamicin for treatment of a respiratory tract infection. The provider instructs the client to monitor and report which of the following adverse effects of gentamicin? a. Blurred vision b. Tremor c. Sweating d. Tinnitus

b. Report mouth pain c. Take 1 hr before meals d. Wear sunscreen and protective clothing

A client is prescribed oral tetracycline for treatment of acne vulgaris. When instruction the client about the tetracycline, which of the following information should the provider include? Select all that apply. a. Increase weight-bearing activity b. Report mouth pain c. Take 1 hr before meals d. Wear sunscreen and protective clothing e. Swallow pill with 8 oz. milk

d. Vancomycin

Because a client is allergic to penicillin, which of the following antibiotics is appropriate to prescribe for the meningitis? a. Cephalexin b. Amoxicillin c. Cefotetan d. Vancomycin

b. Hearing loss

Clients receiving vancomycin should be closely monitored for which of the following? a. Visual disturbances b. Hearing loss c. Perioral numbness d. Metallic taste

c. Epinephrine

If a client is allergic to penicillin, which of the following drugs should be available in case the client has a severe allergic reaction to the antibiotic that has been prescribed? a. Atropine b. Naloxone c. Epinephrine d. Neostigmine

a. Do not mix it with other drugs c. Monitor the IV insertion site for phlebitis d. Monitor vital signs during the infusion e. Dilute the drug before administering it

Intravenous vancomycin has been prescribed to treat meningitis. When administering this drug IV, which of the following actions should the health care professional take? Select all that apply. a. Do not mix it with other drugs b. Administer it rapidly via IV bolus c. Monitor the IV insertion site for phlebitis d. Monitor vital signs during the infusion e. Dilute the drug before administering it

c. Increase fluid intake

Which of the following interventions may prevent a serious adverse reaction to acyclovir? a. Premedicate with a non steroidal inflammatory drug b. Ambulate after infusion c. Increase fluid intake d. Remain flat for 2 hr after infusion

d. Hypotension

While receiving vancomycin, the client becomes flushed and warm. Which of the following additional adverse reactions to vancomycin should be expected? a. Muscle weakness b. Pupil change c. Ecchymosis d. Hypotension

a. Take with food to reduce gastric distress c. Take with 8 ox oz of acidic liquid, like cola or orange juice, to increase absorption

A client is prescribed itraconazole for treatment of systemic mycoses. The provider should include which information when instructing the client about the administration of itraconazole? Select all that apply. a. Take with food to reduce gastric distress b. Take in the morning to avoid insomnia c. Take with 8 ox. of acidic liquid like cola or orange juice, to increase absorption d. Take with an antacid to reduce dyspepsia e. Increase fluid intake to 2 to 3 L/day if tolerated

b. Sore throat

A client is prescribed trimethoprim/sulfamethoxazole for treatment of a urinary tract infection. The health care provider should instruct the client to monitor and report which of the following, which may indicate a serious adverse effect of trimethoprim/sulfamethoxazole? a. Blurred vision b. Sore throat c. Insomnia d. Swelling in calf

a. Bring in a stool sample for testing

A nurse in a provider's office receives a call from a client who has been taking penicillin V three times daily and report abdominal cramping with blood diarrhea for several days. Which of the following instructions should the nurse give the client? a. Bring in a stool sample for testing b. Take the drug only twice daily c. Use an over-the-counter anti-diarrheal medication d. Return to the clinic for blood work

c. Call emergency services immediately

A nurse in a provider's office receives a call from a client who is taking amoxicillin to treat a respiratory infection and reports a rash and wheezing. Which of the following instructions should the nurse give the client? a. Wait 1 hr and contact the provider if there is no improvement b. Skip today's dose of amoxicillin and take the drug tomorrow c. Call emergency services immediately d. Take an NSAID to reduce skin and airway inflammation

a. Take an antacid at least 2 hr after taking the drug

A nurse in a provider's office receives a call from a client who is taking ciprofloxacin to treat a respiratory infection and reports dyspepsia. Which of the following instructions should the nurse give the client? a. Take an antacid at least 2 hr after taking the drug b. Take the drug with a cup of coffee c. Take an iron supplement with the drug d. Take the drug with 240 mL (8 oz) of milk

b. Clostridium difficile-associated diarrhea

A nurse in a provider's office receives a call from a client who is taking tetracycline orally to treat a chlamydia infection and reports severe blood-tinged diarrhea. The nurse should suspect the client is experiencing which of the following? a. Hemorrhoids b. Clostridium difficile-associated diarrhea c. Diverticular disease d. Small bowel obstruction

b. Superinfection

A nurse in a provider's office receives a call from a client who was recently hospitalized and treated with imipenem IV for a bacterial infection and reports and inability to eat due to mouth pain. The nurse should identify that the client might be experiencing which of the following as an adverse effect of this drug? a. Malabsorption b. Superinfection c. Anorexia d. Dental caries

d. Stop the cefotetan infusion

A nurse is administering cefotetan IV to a client to treat an intra-abdominal infection. The nurse notes that the IV insertion site is warm, edematous, and painful to the touch. Which of the following actions should the nurse take? a. Decrease the rate of the cefotetan infusion b. Administer diphenhydramine to the client c. Request a prescription for another antibiotic d. Stop the cefotetan infusion

d. Cefotetan e. Metronidazole

A nurse is caring for a client who has a gynecologic infection and a history of alcohol use disorder. The nurse should identify that which of the following drugs can cause a reaction similar to disulfiram if the client drinks alcohol white taking it? Select all that apply. a. Nitrofurantoin b. Amoxicillin c. Aztreonam d. Cefotetan e. Metronidazole

b. Third generation cephalosporins

A nurse is caring for a client who has a new diagnosis of bacterial meningitis. The nurse should expect the provider to prescribe a drug from which of the following classifications of antibiotics? a. First generation cephalosporins b. Third generation cephalosporins c. Monobactams d. Macrolides

c. BUN

A nurse is caring for a client who has a new prescription for acyclovir to treat a herpes simplex infection. Which of the following laboratory values should the nurse monitor for this client? a. Prothrombin time b. Hct c. BUN d. Aspartate aminotransferase

d. Renal impairment

A nurse is caring for a client who has a new prescription for aztreonam to treat a respiratory tract infection. Which of the following findings in the client's medical record should the nurse recognize as requiring cautious use for the prescription and report to the provider? a. Glaucoma b. Closed-head injury c. Heart failure d. Renal impairment

c. Isoniazid

A nurse is caring for a client who has a prescription for rifampin to treat tuberculosis. The nurse should expect the provider to prescribe which of the following drugs to the client to prevent possible resistance to the rifampin? a. Gentamicin b. Vancomycin c. Isoniazid d. Metronidazole

b. Azithromycin

A nurse is caring for a client who has streptococcal pharyngitis and an allergy to penicillin. The nurse should recognize that which of the following drugs can be safely administered to this client? a. Nafcillin b. Azithromycin c. Cephalexin d. Amoxicillin/clavulanic acid

c. Urine output

A nurse is caring for a client who is about to begin gentamicin therapy to treat an infection. The nurse should monitor the client for an alteration in which of the following? a. Bowel function b. Peripheral pulses c. Urine output d. Level of consciousness

b. Dehydration

A nurse is caring for a client who is about to begin receiving acyclovir IV to treat a viral infection. The nurse should recognize that cautious use of the drug is essential if the client also has which of the following conditions? a. Heart failure b. Dehydration c. Asthma d. Tinnitus

a. Jaundice b. Numbness of the hands c. Dizziness

A nurse is caring for a client who is about to begin taking isoniazid to treat tuberculosis. The nurse should instruct the client to report which of the following adverse effects of the drug? Select all that apply. a. Jaundice b. Numbness of the hands c. Dizziness d. Hearing loss e. Oral ulcers

c. Swelling of hands or feet

A nurse is caring for a client who is about to begin taking itraconazole to treat a fungal infection. The nurse should instruct the client to report which of the following adverse effects of the drug? a. Tingling in the hands and feet b. Joint pain c. Swelling of hands or feet d. Excessive sweating

a. Seizure disorder

A nurse is caring for a client who is about to begin taking metronidazole to treat an anaerobic intra-abdominal bacterial infection. The nurse should recognize that cautious use of the drug is indicated if the client also has which of the following conditions? a. Seizure disorder b. Hearing loss c. Asthma d. Anemia

c. Cough

A nurse is caring for a client who is about to begin taking nitrofurantoin to treat a urinary tract infection. The nurse should tell the client to report which of the following adverse effects of the drug? a. Constipation b. Dark brown urine c. Cough d. Tremors

d. Tendon pain

A nurse is caring for a client who is taking ciprofloxacin to treat a urinary tract infection. The client also takes prednisolone to treat rheumatoid arthritis. Recognizing the adverse effects of ciprofloxacin, the nurse should instruct the client to report which of the following adverse effects? a. Tachycardia b. Hair loss c. Insomnia d. Tendon pain

a. Bleeding

A nurse is caring for a client who is taking warfarin and has a new prescription for trimethoprim/sulfamethoxazole to treat a urinary tract infection. The nurse should clarify the prescriptions with the provider because taking these two drugs concurrently can increase the client's risk for which of the following? a. Bleeding b. Thrombus c. ECG changes d. Ototoxicity

d. Vancomycin

A nurse is caring for a client whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). The nurse should recognize that which of the following medications will likely be administered to the client? a. Trimethoprim/sulfamethoxazole b. Tetracycline c. Cephalexin d. Vancomycin

c. Acetaminophen d. Diphenhydramine

A nurse is preparing to administer amphotericine B IV to a client who has a systemic fungal infection. Which of the following drugs should the nurse prepare to administer prior to the infusion to prevent or minimize adverse reactions? Select all that apply. a. Aspirin b. Hydrocortisone c. Acetaminophen d. Diphenhydramine e. Ibuprofren

d. Use a non-hormonal form of contraception

A nurse is providing teaching for a client who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. Which of the following instructions should the nurse include? a. Increase the rifampin dose b. Increase the oral contraceptive dose c. Allow 2 hr between taking the two drugs d. Use a non-hormonal form of contraception

a. Ethacrynic acid

A nurse is reviewing a client's prescription prior to administering gentamicin to the client to treat a systemic infection. The nurse should clarify the use of gentamicin with the provider if the client is taking which of the following drugs? a. Ethacrynic acid b. Diphenhydramine c. Acetaminophen d. Levothyroxine

ketoconazole

therapeutic use: cutaneous fungal infections

cephalexin

therapeutic use: gram-positive infections

chloroquine

therapeutic use: malaria