Ch 9 Antibiotics - prep/picm
Which statement by a client taking a sulfonamide requires further instruction?
"I will make sure to use extra sunscreen when I go to the tanning booth." - No because clients should avoid any exposure to sunlight or ultraviolet light
What administration instructions should the nurse provide to the parents of a 4-year-old child prescribed a neomycin-polymyxin B-hydrocortisone combination drug for otitis media in the right ear?
"Place three drops into the right ear four times a day."
A client scheduled for a bowel resection is to receive neomycin sulfate by mouth. The client asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the client?
"The administration will decrease the growth of intestinal bacteria"
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response
Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur.
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform? (AMOXICILLIN PREFERRED)
Assess the child for allergies to penicillins.
After teaching a group of nursing students about otic preparations, the instructor determines that the teaching was successful when the group correctly chooses which preparations as being used to aid in the removal of cerumen? Select all that apply.
Carbamide peroxide Triethanolamine polypeptide
Tetracyclines should be used with caution in children younger than age 8 years because the drugs can potentially damage developing
Develiping teeth and bones
Which of the following drugs would be classified as an aminoglycoside?
Gentamicin (GNATS)
The tetracyclines are effective against a wide range of which type of organisms?
Gram-positive and gram-negative organisms
An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH?
HEPATOXICITY Although INH is the drug of choice for treatment of LTBI, its use is controversial in older adults. Because risks of drug-induced hepatotoxicity are higher in this population
A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective
I will apply it in a very thin layer over the area
Penicillin G benzathine is given
IM, may cause death if given IV
A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?
INH, rifampin, pyrazinamide, ethambutol
clarithromycin is a
Macrolide
The nurse should anticipate the administration of what drug when an older adult is diagnosed with community-acquired pneumonia?
Morifloxacin
The action of tetracycline makes it effective for treating
Mycoplasma, Chlamydia, and Rickettsia
The nurse should monitor the client for which common side effects of erythromycin therapy? (Macrolide?)
Nausea, vomiting, and diarrhea
Fluoroquinolones, such as norfloxacin (Noroxin), are commonly prescribed antibiotics given to treat which of the following?
Norfloxacin (Noroxin) is commonly used to treat urinary tract infections and sexually transmitted diseases.
Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to PREVENT bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?
PENICILLIN
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?
Serum BUN and creatinine levels because the two increase the risk of toxicity
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
Serum alanine transaminase, aspartate transaminase, and bilirubin
The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?
Teeth
An older adult client has a feeding tube in place to manage dysphagia. After developing an infected pressure ulcer, ciprofloxacin suspension has been prescribed via feeding tube. How should the nurse follow up this prescription?
The nurse should liaise with the care provider to provide an alternative route of administration.
42s A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
The nurse should monitor for bleeding gums when the drug is administered in combination with anticoagulants, because patients who receive oral anticoagulants may experience increased bleeding
sulfonamides are
bacteriostatic drugs that were once effective against a wide range of gram-positive and gram-negative bacteria.
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic?
decreased absorption
Which medication is the drug of choice for Legionnaires disease?
erythromycin, prototype macrolide
In preparation for administering ciprofloxacin for the treatment of necrotizing otitis externa, what intervention should the nurse implement?
establish intravenous ACCESS
After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication
gram-negative INFECTIONS
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?
he nurse should instruct the patient to avoid the consumption of alcohol since alcoholism compounds patient's difficulties and complicates the general condition of the patient's gastrointestinal tract
Ciprofloxacin is the drug of choice for
necrotizing otitis externa
Gentamicin therapy is indicated in the treatment of what medical diagnosis?
osteomyelitis
Lomefloxacin may induce serious photosensitivity reactions and should be discontinued at the first sign of
photosensitivity - rash, redness, or burning sensation on the skin
A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following
primary and secondary
client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client?
renal damage
A client has a history of a life-threatening anaphylactic reaction to penicillin G. Which medication should not be administered to this client?
Cefadroxil (Duricef) is a first-generation cephalosporin. Administration of cephalosporins or carbapenems should be avoided in individuals with life-threatening allergic reactions to penicillin
The nurse is observing a graduate nurse administering medications. The other nurse would intervene if the graduate nurse attempted to give what medication intravenously?
Penicillin G benzathine
Cephalosporins are structurally and chemically related to which classes of antibiotics?
Penicillins
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?
Rifampin and isoniazid
A client is prescribed rifampin. What information should the nurse include in the client's medication education?
The urine, tears, sweat, and other body fluids will be a discolored red-orange.
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?
avoid antacids and drugs that contain zinc or iron
After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?
bactericidal
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
What adverse effect would most likely necessitate discontinuing treatment with isoniazid?
jaundice which is an indication for hepatoxicity
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:
route should be (oral) PO
The nurse will notify the health care provider immediately if the client taking amoxicillin for otitis media is also taking what medication?
tetracycline for acne
A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?
"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant.
A client is diagnosed with VRE, and the health care provider orders chloramphenicol. The nurse should monitor the client for the development of which side effect?
Blood dyscrasia
A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?
By administering the drug in separate IV bags
A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI?
Chlamydia
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic
Chronic renal failure
Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order?
Culture and sensitivity
A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test?
LIVER FUNCTION
26s A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client?
These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.
A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?
To prevent resistance
A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client?
culture sensitivity
The nurse should ensure that renal and hepatic function tests, urinalysis, and tests to determine blood count are conducted if the client is to be
is to be administered aminoglycosides
49s A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the
monitor for adverse reactions
34s A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?
nausea, vomiting, and diarrhea
A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions? (Select all that apply.)
nausea, vomiting, diarrhea, headache, abdominal pain or discomfort, dizziness, and photosensitivity
a nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?
rash and itching
The major clinical use of gentamicin (most commonly with other antibacterial agents) is empiric therapy for
serious infections caused by susceptible aerobic gram-negative organisms. Treatment of infections such as septicemia, respiratory tract infections, urinary tract infections, intra-abdominal infections, and osteomyelitis often involves gentamicin
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed
trimethoprim-sulfamethoxazole
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
with a glass of water 1 hour before or 2 hours after a meal.
