Chapter 9: Antibiotics

A nurse suspects that a client receiving oral penicillin therapy is developing pseudomembranous colitis based on which assessment finding?

Bloody Diarrhea

Selective toxicity, or the ability to affect certain proteins or enzyme systems in the infecting organism, is a much sought-after quality of an anti-infective agent. How many anti-infective agents have this quality?

0%

The caregiver of a 12-year-old, diagnosed with acute otitis externa, has asked if oral medications might be more effective than the prescribed ear drops. The nurse should respond in the knowledge that systemic medications for the treatment of otitis externa are only indicated in what circumstance?

A deep tissue infection develops

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe?

Amoxicillin

A 26-year-old female client with a skin infection has been prescribed 400 mg ampicillin to be taken orally. Which instruction should the nurse include in the client teaching plan?

Ampicillin will reduce the effectiveness of birth control pills.

A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?

Cefadroxil

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 antiobiotic.

Which of the following would a nurse identify as the prototype lincosamide drug?

Clindamycin

A hospital client's infection is being treated with gentamicin. When reviewing the results of the client's morning laboratory results for signs of adverse effects, the nurse should pay particular attention to what laboratory value?

Creatinine clearance

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

What pharmacologic principle causes nephrotoxicity when gentamicin is administered?

Distribution

A nurse is caring for a client daignosed with a serious gram-negative infection prescribed amikacin. Which action should the nurse prioritize while caring for this client?

Do renal tests daily

A client who is being discharged has been instructed to continue with sulfonamide therapy for a week. Which point should the nurse include in the teaching plan to educate the client about the therapy?

Ensure that all follow-up appointments are met.

The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?

Fear of Incontinence

A client develops a mild skin irritation while receiving penicillin therapy. Which products or actions would the nurse advise the client to avoid? Select all that apply.

Harsh soaps, perfumed lotions, rubbing the irritated area, wearing rough or irritating clothing.

Which factors should be included in the nurse's pre-administration assessment prior to administering a penicillin to a client? Select all that apply.

History of allergies, Medical history, medication history, and current symptoms

A nurse is caring for a client who is receiving penicillin. The nurse would assess for what common adverse reaction?

Inflammation of the tongue and mouth.

The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?

Inhibiting cell wall synthesis

When describing the action of sulfonamides to a client, the nurse integrates understanding of the drug's action with effects exerted due to which mechanism?

Inhibition of the activity of folic acid in bacterial cell metabolism

A client being treated for tuberculosis is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis?

Isoniazid & Ridampin

A client's upper respiratory infection is believed to be bacterial so the health care provider has prescribed amoxicillin 500 mg PO q8h. How should the nurse best interpret this prescription?

It aligns with the recommended dose, route and indication for this medication.

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?

Jaundice

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

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 alcohol for the next 3 days.

A nurse is assessing a client for possible adverse reactions associated with fluoroquinolone therapy. Which possible reactions would the nurse attribute to this therapy? Select all that apply.

Nausea, diarrhea, abdominal discomfort

Ampicillin-sulbactam is administered to a client with Staphylococcus aureus. What type of anti-infective is ampicillin-sulbactam?

Penicillin-beta-lactamase inhibitor combination

A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?

Phlebitis

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for?

Photosensitivity

The nurse is preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect?

Prolonged clotting times

Overuse of anti-infective agents is known to contribute to the onset of superinfections in the body. What is a causative agent of a superinfection?

Pseudomonas

A nurse is about to administer mafenide to a client. The nurse would be alert for which possible reaction?

Rash, itching, or other allergic reactions

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 This causes face & upper trunk becomes bright red, leading to cardiovascular collapse.

A client in the critical care unit is receiving aminoglycosides for an infectious process. What does the nurse need to monitor?

Renal function tests CC patients are at high risk to develop nephrotoxicity and ototoxicity

The nurse is caring for an older adult client who is being treated for community-acquired pneumonia. Over the past 12 hours, the client has had three episodes of diarrhea despite having no known history of gastrointestinal disease. What is the nurse's best action?

Report this sign of a possible superinfection to the provider.

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 & isoniazid

A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?

Rotate injection sites for frequent parental injections.

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. Ciprofloxacin is given PO.

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

Serum BUN and creatinine levels

Common, potentially serious, adverse effects of antibiotic drugs include:

Skin Rash

After administering sulfonamides to a client, the nurse observes the client has developed a fever, cough, and muscular aches, as well as lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which possible adverse reaction?

Stevens-Johnson Syndrome (SJS) Fever, Cough, Muscle aches/pains, headache and lesions on neck/mouth are common.

A client has been prescribed oral tetracycline for the treatment of acne. Which instruction must the nurse include in the client teaching plan?

Take the drug on an empty stomach

The nurse understands that which is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

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 hospital client has been prescribed IV ceftriaxone, a cephalosporin antibiotic. What assessment finding related to drug therapy would be of greatest concern to the nurse?

The client develops jaundice

A client asks the nurse why fluid intake should be increased while taking sulfonamides. Which response by the nurse would be most appropriate?

The fluids will help to decrease your risk for kidney stones.

When preparing a teaching plan for a group of students about the ways organisms develop resistance to anti-infective therapy, what would the instructor be least likely to include in the discussion?

The organism produces some chemical to mimic the drug.

The nurse is providing education to a client who has been prescribed trimethoprim-sulfamethoxazole. What statement would the nurse include about potential adverse effects?

This drug may make your stomach a bit upset, so let me know if you experience that.

The client reports cough, low-grade fever, anorexia, and night sweats. The client has also been coughing up blood at times. What disease does this client most likely have?

Tuberculosis

A nurse is conducting an in-service about antibacterial drugs such as penicillins and cephalosporins. During the question-and-answer period, the audience asks for examples of conditions that can be treated by cephalosporins. Which examples would the nurse include in the response?

UTI

The nurse is preparing to administer linezolid (Zyvox) to a client. The nurse knows that this drug used in the treatment of which disorders? (Select all that apply.)

Vancomycin-resistant Enterococcus faecium (VREF) Methicillin-resistant S. Aureus (MRSA) Health care acquired pneumonia Skin structure infections

The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects?

Vomiting and Diarrhea

A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug?

Warfarin

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?

Your urine or sweat may become orange in color.

A 54-year-old woman with a history of osteoporosis has been prescribed ciprofloxacin for recurrent cystitis. Because of the patient's history, the nurse would be sure to discuss with the woman the use of

food containing iron or calcium

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 client, diagnosed with a urinary tract infection, indicates the use of an herbal product to help prevent and relieve the symptoms. Which herb has the client most likely been using?

Cranberry

A client with a complex medical history is scheduled to begin with an IV cephalosporin. After the initiation of therapy, the nurse should monitor the client for which potential adverse effect of intravenous cephalosporin therapy? Select all that apply.

Nausea and vomiting, abdominal pain, diarrhea

A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?

Refer the client to the health care provider because the client may be experiencing resistance.