Chapter 35

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What is the action of bactericidal drugs?

They will kill the bacteria.

The physician orders cefepime (Maxipime) for a client. What is a priority question for the nurse to ask the client prior to administration of this drug?

"Are you allergic to penicillin?"

The physician orders penicillin for a female client who has a sinus infection. What is a priority question to ask the client prior to administering the medication?

"Are you taking birth control pills?"

The client is prescribed amoxicillin (Amoxil) for 10 days to treat strep throat. After 5 days, the client tells the nurse he plans to stop the medication because he feels better. What is the best response by the nurse?

"If you stop the medicine early, you have not effectively killed out the bacteria making you sick."

The client receives multiple drugs for treatment of tuberculosis. The nurse teaches the client the rationale for multiple drug treatment and evaluates learning as effective when the client makes which statement?

"Multiple drugs are necessary because the bacteria are likely to develop resistance to just one drug."

The nurse works in infection control and teaches a class to staff nurses about the ways that resistance to antibiotics can occur. The nurse evaluates that learning has occurred when the nurses make which statement?

"Resistance to antibiotics can occur by the common use of them for nosocomial infections."

The client tells the nurse that the doctor told him his antibiotic did not kill his infection but just slowed its growth. The client is anxious. What is the best response by the nurse to decrease the client's anxiety?

"This is okay because your body will help kill the infection too."

A patient has been diagnosed with tuberculosis and is prescribed Rifater (pyrazinamide with isoniazid and rifampin). While the patient is on this medication, what teaching is essential? (Select all that apply.)

1. "It is critical to continue therapy for at least 6 to 12 months." 2. "Two or more drugs are used to prevent tuberculosis bacterial resistance." 3. "These drugs may also be used to prevent tuberculosis."

A client has been diagnosed with multidrug-resistant tuberculosis, and drug therapy has been initiated. The nurse evaluates that medication education has been effective when the patient says, "I can expect to take this medication for up to _____ months."

24

What important information should be included in the patient's education regarding taking ciprofloxacin (Cipro)?

Any heel or lower leg pain should be reported immediately.

A 32-year-old female has been started on amoxicillin (Amoxil, Trimox) for a severe UTI. Before sending her home with this prescription, the nurse will provide which instruction?

Ask her about oral contraceptive use and recommend an alternative method for the duration of the ampicillin course.

The client receives multiple antibiotics to treat a serious infection. What will the priority assessment of the client by the nurse include?

Assessing changes in stool, white patches in the mouth, and urogenital itching or rash

Which laboratory tests will be performed to determine whether a specific bacterium is resistant to a specific drug?

Culture and sensitivity test

Discharge planning for the client prescribed tetracycline will include which instruction?

Do not take the medication with milk.

The client has MRSA and receives vancomycin (Vancocin) intravenously (IV). The nurse assesses an upper body rash and decreased urine output. What is the nurse's priority action?

Hold the next dose of vancomycin (Vancocin) and notify the physician.

The drug that would most likely be used in the treatment of tuberculosis is

Isoniazid

A patient has been prescribed tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline?

It is contraindicated in children younger than 8 years.

The client receives gentamicin (Garamycin) intravenously (IV) in the clinical setting. What is a priority nursing action?

Monitor the client for hearing loss.

A client comes to the emergency department with a fever of 104°F. The nurse anticipates which actions to help identify the correct antibiotic?

Obtaining blood for culture and sensitivity.

A client comes to the emergency department complaining of a sore throat. He has white patches on his tonsils, and he has swollen cervical lymph nodes. What will the best plan by the nurse include?

Plan to obtain a throat culture.

A patient will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include?

The entire prescription must be finished.

Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection?

The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora

Following surgery, a client is placed on cefotaxime (Claforan). The assessment for possible adverse effects should include observing for

diarrhea.

Pathogenicity is different than virulence in that pathogenicity can

lead to the ability of organisms to cause infection.

The nurse is caring for a client receiving gentamicin IV. The nurse would observe for adverse effects of

ototoxicity.

Treatment of tuberculosis usually involves

the use of two or more drugs at the same time.


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