CHAPTER 7: antibacterial drugs that disrupt the bacterial cell wall
A client has just received a first dose of intravenous nafcillin when he immediately begins to have difficulty breathing and loses consciousness. The nurse takes the client's vital signs: blood pressure is 88/50 with a pulse oxygenation of 88%. What should the nurse suspect?
Anaphylactic reaction
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
Beta-lactam antibiotics, such as penicillins and cephalosporions, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect?
Cell wall synthesis
Natural penicillins have been available since 1941 to treat infections. What problem has developed since 1941?
Drug-resistant strains of microorganisms have developed
A 4-year old client being discharged from the hospital is ordered an oral-suspension cephalosporin. When the nurse instructs the mother to store the bottle in the refrigerator, the mother asks, "why does that matter?" The nurse's best response would be which?
Drugs that require refrigeration lose potency if kept at room temperature
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?
It inhibits cell wall synthesis
Cephalosporins might interfere with the accuracy of which test?
Ketone urine test
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?
Make sure to avoid drinking any alcohol for the next three days
A 25-year old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:
Oral contraceptives
The nurse is caring for a client diagnosed with syphilis. The client has no known drug allergies. Which medication can the nurse expect to be ordered for this client?
Penicillin
What event triggers the development of a superinfection?
Proliferation of antibiotic-resistant microorganisms
A 36-year old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days after surgery. This is a case of which type of therapy?
Prophylaxis
The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections?
Pseudomembranous colitis
The nurse has adiministered the first dose of a client's newly-prescribed antibiotic. What assessment finding should the nurse interpret a adverse effect that suggests a more serious concern?
Rash to the face and trunk
The nurse is aware that drug resistance has significantly increased. Client education must be reinforced so that complete regimens of medications are taken. In which situation would one expect to find an issue with drug resistance?
Residents in a long-term care facility
A 34-year old female client is taking cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The client reports gastrointestinal distress. The nurse will encourage the client to do which?
Take the drug with food
A client has been diagnosed with a sinus infection, and the client has been given a prescription for amoxicillin. What teaching point should the nurse make for the client?
Take your medication every 8 hours, as it's been prescribed
How will a client's diagnosis of liver cirrhosis affect the potential use of appropriate ampicillin therapy to treat an infected pressure ulcer?
The client can safely be treated with ampicillin
A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?
The client has a new onset of jaundice and edema
A 64-year old client is admitted to your unit with exacerbation of chronic heart failure and pneumonia and started on cefixime. On the third hospital day, you are assessing the client and note white patches in his mouth, and he is complaining of diarrhea. What would be the most likely reason for these symptoms?
The client has developed a superinfection because the antibiotic has destroyed the normal bacterial flora in his body
The nurse is caring for a 23-year old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client?
Use a type of barrier controls while you are taking this antibiotic
The nursing instructor is teaching about a new emerging bacteria that has both natural and acquired resistance and that affects the severely ill, immunocompromised clients in intensive care, transplant, and some cancer treatment units. This is which?
VRE
The client calls the clinic to report that he is experiencing a throbbing headache and his face is flushed. The client received cefotetan as an IV antibiotic prior to a minor surgical procedure the day before, and returned home the same day. What has this client consumed that has caused this reaction?
Alcohol
The nurse is giving instructions to a client who is being discharged home with a prescription for Augmentin. The nurse informs the client that the best time to take this medication is:
1 hour before meals and 2 hours after a meal
A client has been started on Augmenting 250 mg P.O. every 12 hr. It is supplied in 500 mg tablets. How much will the nurse give at each dose?
1/2 tablet
Penicillin would NOT be indicated for which of the following clients?
A client with gram-negative bacteria allergic to penicillin
When learning about the different classes of cephalosporins, the nurse correctly identifies which of the following statements?
A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms
