NUR 3420 Pharmacology PrepU ch21

The patient is receiving vancomycin (Vancocin) intravenously. The nurse assesses the patient and finds that the patient has flushed skin, a rash, and a drop in blood pressure. Which of the following actions probably has happened?

The IV infusion is too fast.

Which client should not receive erythromycin as ordered at 8 a.m.?

The client with elevated liver enzymes

What medication could be prescribed orally to treat a sinus infection in a client needing an abbreviated therapy plan?

azithromycin

A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?

changing to a different antibiotic

A client has an upper respiratory infection and is allergic to penicillin. What medication does the nurse expect will be ordered?

erythromycin

A client reports having had a "bad reaction" the last time receiving penicillin. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug?

erythromycin

What medication would the nurse anticipate being prescribed for a client diagnosed with trichomoniasis?

metronidazole

What information will the nurse teach the client being switched to azithromycin from erythromycin?

"This drug has enhanced antibacterial activity."

Linezolid (Zyvox) can be used to treat which of the following infections? Select all that apply.

- Community-acquired pneumonia (CAP) -Vancomycin-resistant Enterococcus faecium (VREF) -Methicillin-resistant Staphylococcus aureus (MRSA) -Nosocomial pneumonia

Metronidazole (Flagyl) can be described in which of the following ways? Please choose all that apply

- Effective against anaerobic bacteria - Used in colorectal surgery, intra-abdominal infections - Treatment of C. difficile infections associated with pseudomembranous colitis

Your patient is receiving a miscellaneous anitbacterial to treat an infection. Which of the following goals would be appropriate to include in your plan of care? Select all that apply.

- The patient will take or receive miscellaneous antimicrobials accurately, for the prescribed length of time. - The patient will be monitored regularly for therapeutic and adverse drug effects. - The patient will verbalize and practice measures to prevent recurrent infection.

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.

- drop in blood pressure - sudden increase in temperature - increase in respiratory rate

How long should an infusion of vancomycin be programmed to run to minimize the client's risk of developing symptoms associated with excessive histamine release?

1 to 2 hours

You are a pediatric nurse caring for a child receiving erythromycin ethylsuccinate. The recommended dose for this drug is 30 mg/kg/day. The child weighs 20 kg, and the medication is to be administered q8h. How much medication should this child receive per dose?

200 mg

A male client presents to the emergency department with an abdominal dehiscence. He states he had a hernia repair 18 days earlier, and the health care provider removed his wound staples 5 days ago. The client states that the dehiscence occurred when he lifted a box this morning for his wife. The wound is red, and there is evidence of foul-smelling drainage. The wound is cultured, and an anaerobic bacterium is identified. The nurse understands that the provider orders metronidazole because it is effective against which type of organism?

Anaerobic bacteria

You are caring for a 60-year-old female patient who is expected to undergo extended treatment with linezolid. What lab value may require close monitoring during drug therapy?

Complete blood count

A patient with acne vulgaris was administered macrolides, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case?

Inspect stools for blood or mucus.

A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor?

It is important to use antibiotics cautiously and to teach clients to complete the full course of an antibiotic prescription.

Which statement is true concerning macrolides?

Macrolides are bacteriocidal or bacteriostatic

The nurse should monitor the client for which common side effects of erythromycin therapy?

Nausea, vomiting, and diarrhea

A nurse is caring for a client with severe and life-threatening pseudomembranous colitis caused by C. difficile. Which drug would the nurse expect the client's provider to order?

Oral vancomycin

A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?

culture tests

A client developed a pressure area on the hip that has become infected. If the wound culture reveals methicillin-resistant Staphylococcus aureus, which medication would the nurse expect to be prescribed?

vancomycin

A client has been prescribed metronidazole for treatment of Giardia. What instruction is most important for the nurse to give to this client?

Do not drink alcohol while taking this medication.

A health care provider is deciding what medication to prescribe for a client with an upper respiratory infection. What principles guide the provider's decision? Select all that apply.

- Resistance of the bacteria - Other drugs the client is taking daily -The client's ability to tolerate the drug

Which of the following drugs are considered to be macrolides? Choose all that apply

- erythromycin - azithromycin (Zithromax) - clarithromycin (Biaxin)

A health care provider is deciding what medication to prescribe for a client with an upper respiratory infection. What principles guide the provider's decision? Select all that apply

-Resistance of the bacteria - Other drugs the client is taking daily - The client's ability to tolerate the drug

The nurse realizes that vancomycin is a powerful drug and can treat serious gram-positive infections that do not respond to treatment with other anti-infectives. Serious adverse effects classic for vancomycin include which of the following? (Select all that apply.)

-nephrotoxicity - ototoxicity

A patient is required to be administered vancomycin for treatment of an abdominal abscess. What should the nurse ensure when monitoring the IV infusion of vancomycin in the patient when caring for him?

Administer each dose over 60 minutes.

Bacterias have readily evolved. Which type of bacteria are most commonly resistant to vancomycin?

Enterococci

Rifaximin (Xifaxan) is effective to treat traveler's diarrhea from which of the following organisms?

Escherichia coli

A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice

It is metabolized in the liver.

A 22-year-old female is admitted to the unit with pseudomembranous colitis related to C. difficile. What drug would the nurse expect the provider to order for this client?

Metronidazole

A client develops antibiotic-induced colitis. The symptoms have worsened within the past 72 hours. The nurse expects the health care provider to order what medication, which is considered the initial drug of choice?

Metronidazole

John, 34 years old, is being treated with clindamycin for osteomyelitis of his tibia following an open fracture 3 months ago. The nurse is teaching John how to properly administer the medication at home and the side effects that he needs to report to the health care provider. Which would be the best instruction to give John?

Notify the provider if you have any blood in your stool or diarrhea.

The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present?

Perform culture and susceptibility tests.

A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Review lab results to confirm normal liver function.

Which client should be assessed further before receiving azithromycin (Zithromax) as ordered?

The client who is taking digoxin

A patient on your unit has bacterial colitis and is being treated with oral vancomycin. Why is vancomycin given orally, rather than intravenously, in the treatment of bacterial colitis?

The oral version of the drug acts within the bowel lumen

A client received erythromycin before dental surgery. The client has a past history of a cardiac surgery. The rest of the client's history is unremarkable. What does the nurse teach the client about this medication?

You are receiving this medication to prevent infection that may affect your heart."

What antibiotic is contraindicated for the treatment of intermittent colitis?

clindamycin

An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin?

diarrhea

A common reaction associated with the intravenous administration of vancomycin is "red man syndrome." What is the cause of red man syndrome?

histamine release

A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient?

it is taken only once a day

The client has developed a pressure area on her hip that has become infected. If the wound culture reveals vancomycin-resistant enterococci (VRE), which medication will the nurse expect to be prescribed?

linezolid

In which condition present in the client should macrolides be used with caution?

liver dysfunction

The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?

red man syndrome