ch 21 prep u pharm

After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following?

"I should drink a full 8-oz glass of water when I take the medicine."

A client has been prescribed daptomycin for treatment of an infection. What instruction is most important for the nurse to tell this client?

"Tell the health care provider immediately if you develop any muscle pain."

The nurse is discussing the administration of clindamycin with a group of novice nurses. The experienced nurse should include which statement(s) to help ensure client safety? Select all that apply.

"You need to dilute 600 mg of clindamycin in at least 50 ml of IV fluid and deliver it over 10-20 minutes in order to decrease the risk of phlebitis." "Reconstituted oral clindamycin needs to be stored at room temperature to maintain its pourability." "Never administer clindamycin as a bolus since that can trigger cardiac arrest." "Neonates and infants prescribed clindamycin require close monitoring of both their renal and hepatic functioning."

The nurse is preparing to administer IV vancomycin to a client for the treatment of a systemic infection. How long would the nurse expect the infusion to run?

1 to 2 hours

The client is ordered vancomycin IV 500 mg every 12 hours to infuse over 1 hour. The medication vancomycin 500 mg comes in a 100-ml bag of normal saline. At what rate should the nurse set the pump to infuse the vancomycin?

100 ml/hour

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 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.

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

The nursing instructor is discussing the administration of azithromycin, a macrolide, with her clinical group. The instructor asks her students to identify the medication that will decrease the effects of azithromycin when administered concurrently. Which of the following medications would the students identify?

Antacids

A patient taking erythromycin (E-mycin) is having difficulty hearing the nurse. How should the nurse proceed?

Ask about the patient's hearing prior to medication therapy.

A newborn presents with a distended abdomen, shallow and irregular respirations, and cyanosis. The nurse recognizes this as gray syndrome as a result of administration of which antibiotic?

Chloramphenicol (Chloromycetin)

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

Erythromycin

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 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.

An 82-year-old client, who lives alone and has occasional memory lapses, is being seen by the home health nurse. In reviewing the client's medication, the nurse discovers that the client was recently prescribed azithromycin for urethritis. What characteristic of this drug makes it an appropriate choice for this client?

It is taken only once a day.

A client presents to the health care provider's office with a skin infection on the forearm. The infection is resistant to over-the-counter antibiotics. After receiving the culture and sensitivity results, the provider orders tigecycline. The nurse knows that this client has what illness?

MRSA

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.

A client with an infected ulcer on the foot has been prescribed daptomycin. What action should the nurse ensure has been taken to determine that the drug will be effective in treating the infection?

Obtain a culture of the client's infection.

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 client who has been receiving intravenous (IV) vancomycin begins to report neck and back pain as well as feeling hot and having chills. The nurse assesses the client and notices that the neck is red. The client's temperature is 102 degrees F; BP is 86/58. This client is showing signs and symptoms of which syndrome?

Red-man syndrome

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

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 not receive erythromycin as ordered at 8 a.m.?

The client with elevated liver enzymes

Which client should not receive erythromycin (E-mycin) as ordered without further investigation?

The client with myasthenia gravis

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.

Your patient is receiving a miscellaneous antibacterial 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 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 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.

decrease in blood pressure increase in respiratory rate sudden increase in temperature

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

erythromycin azithromycin (Zithromax) clarithromycin (Biaxin)

The nurse is caring for a client who has been diagnosed with trichomoniasis. What medication would the nurse anticipate being prescribed?

metronidazole

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