Chapter 9: Antibiotics

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active TB. What question should the provider ask this client before confirming this order? "Have you ever experienced a miscarrage?" "Are you allergic to penicillin?" "Are you pregnant?" "Do you have a family history of diabetes?"

"Are you pregnant?"

A 5-year-old child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem? -"Are all of your child's immunizations up-to-date?" -"How would you describe your child's overall level of hygiene?" -"Has he been swimming a lot in the last little while?" -"Has your child been spending quite a bit of time around animals lately?"

"Has he been swimming a lot in the last little while?"

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? -"Remember to have your required blood work drawn in 48 hours." -"Make sure to avoid drinking any alcohol for the next three days." -"It's possible that your urine might be pink-tinged for the next little while, but that's expected and it will resolve." -"You might develop a mild fever when you finish your antibiotics, but that doesn't mean your infection has returned."

"Make sure to avoid drinking any alcohol for the next three days."

A client diagnosed with TB has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question? -"Multiple drugs are prescribed because the final testing results for TB can take up to 3 months." -"The use of multiple drugs prevents the development of drug-resistant TB." -"Multiple drugs are used to speed up the course of treatment." -"Multiple drugs are used because health care providers aren't sure which drug will kill a particular TB strain."

"The use of multiple drugs prevents the development of drug-resistant TB."

A 15-year-old female client is receiving tetracycline for the treatment of severe acne. Which statement would the nurse make when teaching the client about this drug? -"When taking tetracycline, wear extra sunblock and watch for discoloration of your teeth." -"You need to have lab work done daily to ensure the proper dose of this medication." -"Tetracycline can only be administered here in the hospital." -"A change in diet is a better treatment for acne than medication."

"When taking tetracycline, wear extra sunblock and watch for discoloration of your teeth."

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client? -"You might experience some nausea or stomach upset." -"The drug can cause an allergic reaction." -"Call your health care provider if you experience headache or dizziness." -"Your urine or sweat may become orange in color."

"Your urine or sweat may become orange in color."

Macrolides side effects

-AMS -Hypersensitivity -Superinfections

Tetracyclines: indications

-Acne -GU infections -Chlamydia -Lyme disease -pneumonia -anthrax -GI infections

Macrolides MOA

-Bind to the subunit of the ribosome, interfering with protein synthesis. -Prevents cell division or cell death depending on the concentration of the drug

Aminoglycosides: Drug Interactions

-Diuretics -Neuromuscular Blocking Agents

Sulfonamides: side effects

-stomatitis -hepatic injury -crystalluria -hematuria -proteinuria -nephrotic syndrome -toxic nephrosis -vertigo -convulsions -depression -bone marrow depression -Blood dyscrasias -photosensitivity

Normal Creatinine

0.6-1.2

Normal BUN levels

10-20

Normal urine output

1200 mL/day

liver function tests

AST ALT

Penicillins & Penicillinase-Resistant Antibiotics: contraindications

Allergy to PCN or cephalosporins

Cephalosporins: drug interactions

Aminoglycosides ETOH

Fluoroquinolones: drug interactions

Antacids warfarin theophylline

What leads to antibiotic resistance?

Bacteria adapt to their environment by altering the cell wall or enzyme systems

Monobactam cidal or static?

Bactericidal

Oxazolidinones cidal or static?

Bactericidal

Cephalosporins: cidal or static?

Bactericidal and Bacteriostatic

Macrolides: cidal or static

Bactericidal and Bacteriostatic

lincosamides -cidal or -static

Bactericidal and Bacteriostatic

Ketolides: MOA

Blocks protein synthesis by binding to specific ribosome subunits, leading to cell death

Which of the following info should the nurse obtain during the pre-administration assessment of a client prescribed a fluoroquinolone or miscellaneous anti-infective? (Select all that apply.) Blood pressure Signs and symptoms of infection Temperature Allergy history Blood glucose

Blood pressure Signs and symptoms of infection Temperature Allergy history

Tetracyclines

Broad spectrum antibiotic against gram-positive & gram-negative bacteria

Cephalosporins

Broad-spectrum antibiotic effective against gram-positive and gram-negative bacteria

Fluoroquinolones

Broad-spectrum antibiotic treat infections caused by gram-negative and gram-positive bacteria

Carbapenems

Broad-spectrum antibiotics effective against gram-positive, gram-negative bacteria, and anaerobic bacteria

A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a second-line treatment option? Rifampin Capreomycin Kanamycin Ciprofloxacin

Capreomycin Kanamycin Ciprofloxacin

What drug belongs to the group of second-generation cephalosporin? Primaxin Cefuroxime Demeclocycline Gemifloxacin

Cefuroxime

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect? Protein synthesis Cell wall synthesis DNA replication Cell division

Cell wall synthesis

What symptoms should lead the nurse to suspect that a client receiving a cefuroxime ingested alcohol during treatment? Select all that apply. Pallor Chest pain Throbbing headache Bleeding gums Dyspnea

Chest pain Throbbing headache Dyspnea

Antimycobacterials

Classified by basis of their ability to hold stain even in presence of destaining agent like acid

Lipoglycopeptides indications

Complicated skin and skin structure infections

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current lab report reflects renal impairment. What would the nurse expect the provider to do? Administer the drug via an IM route. Maintain the drug dose. Decrease the drug dose. Increase the drug dose.

Decrease the drug dose

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? Increased elimination Decreased elimination Decreased absorption Increased absorption

Decreased absorption

What drug belongs to the group of tetracycline? Primaxin Cefuroxime Demeclocycline Gemifloxacin

Demeclocycline

Monobactam MOA

Disrupts bacterial cell wall synthesis, which promotes leakage of cellular contents and cell death

Oral ampicillin has been ordered for a client whose UTI will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction? -Taper off the drug rather than abruptly stopping it. -Drink a full glass of water when taking a dose of the drug. -Take the first dose together with diphenhydramine to reduce the chance of an allergic reaction. -Take the drug immediately before a meal, unless the meal will contain large amounts of fat.

Drink a full glass of water when taking a dose of the drug.

What is true regarding the initial phase of tuberculosis therapy? (Select all that apply.) Drugs are used to prevent drug resistance. The initial phase lasts approximately two months. The initial phase lasts approximately six to nine months. The initial phase lasts approximately four months. Drugs are used to kill the rapidly multiplying M. tuberculosis.

Drugs are used to kill the rapidly multiplying M. tuberculosis. Drugs are used to prevent drug resistance. The initial phase lasts approximately two months.

Gram-negative Example

E. coli and Salmonella

Monobactam

Fights gram-negative enterobacteria

What drug belongs to the group of Fluoroquinolones? Primaxin Cefuroxime Demeclocycline Gemifloxacin

Gemifloxacin

After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class? Tobramycin Kanamycin Neomycin Gentamicin

Gentamicin

Why must a client who is receiving aminoglycosides be kept well hydrated? -Hydration increases drug concentration in serum and body tissues. -Hydration decreases drug concentration in serum and body tissues. -Hydration stabilizes peak serum levels. -Hydration stabilizes trough serum levels.

Hydration decreases drug concentration in serum and body tissues.

Antimycobacterials: drug interactions

INH inhibits metabolism of phenytoin

Lipoglycopeptides route

IV only

What three drugs belongs to the group of carbapenems?

Imipenem-cilastatin (Primaxin) Meropenem (Merrem) Ertapenem (Invanz)

Sulfonamides are bacteriostatic against a wide range of gram (+) and gram (-) bacteria, but they are becoming less useful for what reason? Increased susceptibility Decreased resistance Increasing resistance Intermittent resistance

Increasing resistance

Carbapenems: MOA

Inhibit cell membrane synthesis in susceptible bacteria, leading to cell death

Aminoglycosides: MOA

Inhibit protein synthesis. Bind to unit of bacteria ribosomes, leading to misreading of genetic code and cell death.

Tetracyclines: MOA

Inhibits protein synthesis leading to inability of bacteria to multiply

What is a contraindication to use of a fluoroquinolone? Height Lactation Gender Weight

Lactation

Oxazolidinones contraindications

MAOIs Hepatic impairment Pheochromocytoma HTN Hyperthyroidism Bone marrow suppression

Ketolides: contraindications

MS (BLACK BOX WARNING -> RISK OF FATAL RESPIRATORY FAILURE)

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 treatment? Use DOT to administer the drug to the patient. Assess patient's history of contacts. Monitor for appearance of adverse reactions. Monitor patient's vital signs every 24 hours.

Monitor for appearance of adverse reactions.

Fluoroquinolones: side effects

Musculoskeletal effects w/ MS (tendinitis, tendon rupture, peripheral neuropathy, exacerbated muscle weakness) BLACK BOX WARNING

The nurse should monitor the client for which common side effects of erythromycin therapy? Nausea, vomiting, and diarrhea Urticaria and opthalmic drainage Headache and fever Shortness of breath and sore throat

Nausea, vomiting, and diarrhea

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions? -Hypoglycemia and hyperglycemia -Glaucoma and renal failure -Liver necrosis, or hepatic failure -Ototoxicity and nephrotoxicity

Ototoxicity and nephrotoxicity

Lipoglycopeptides contraindications

PREGNANCY/LACTATION (BLACK BOX WARNING -> FETAL RISK)

A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use? Ampicillin Penicillin Cephalexin Erythromycin

Penicillin

Tetracyclines: drug interactions

Penicillin G oral contraceptives Digoxin iron charcoal

Carbapenems: Lab Tests

Perform C&S tests prior to therapy.

The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present? Perform a lumbar puncture to assess cerebrospinal fluid. Assess serum electrolyte levels. Perform culture and susceptibility tests. Perform a CBC test.

Perform culture and susceptibility tests.

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? Fatigue Photosensitivity Muscle cramping Weakness

Photosensitivity

he nurse should advise clients that which of the following are adverse reactions that may occur with the administration of tetracyclines? (Select all that apply.) Diarrhea Photosensitivity Hypoglycemia Hypotension Stomatitis

Photosensitivity Diarrhea Stomatitis

Penicillins & Penicillinase-Resistant Antibiotics: MOA

Prevent bacteria from building cell walls when dividing

What drug belongs to the group of carbapenems? Primaxin Cefuroxime Demeclocycline Gemifloxacin

Primaxin

A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option? Rifampin Capreomycin Kanamycin Ciprofloxacin

Rifampin

A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combos of drugs need to be administered to the client? Rifampin and isoniazid Rifampin and Pyrazinamide Dapsone and isoniazid Pyrazinamide and dapsone

Rifampin and isoniazid

A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for? Severe hypotension Impaired oral mucous membranes Sudden loss of consciousness Inflammation of the tongue and mouth

Sudden loss of consciousness Inflammation of the tongue and mouth

Antimycobacterials: Indications

TB

The nurse understands that which is the highest priority when teaching about antitubercular medications? Eating a well balanced diet Taking meds as prescribed Staying hydrated Monitoring sputum

Taking meds as prescribed

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? -The client has a known latex allergy -The client has chronic renal failure -The client has type 2 diabetes, controlled with oral antihyperglycemics -The client has a history of not adhering to treatment

The client has chronic renal failure

Cephalosporins: Indications

UTI Postop infections pelvic infections meningitis

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? -Your menstrual cycle will have a heavier flow while on this medication. -Use a type of barrier birth control while you are taking this antibiotic. -Do not take your oral contraceptives while you are taking this medication. -Taking this antibiotic with your oral contraceptives will cause an increased chance of bleeding.

Use a type of barrier birth control while you are taking this antibiotic.

Fluoroquinolones: MOA

Using passive diffusion, enters bacterial cell and interferes with action of DNA enzymes needed for growth and reproduction, leading to cell death

Carbapenems: Drug Interactions

Valproic acid (Depakote)

Aminoglycosides must be used cautiously in children as in adults. Dosage must be accurately calculated according to which factors? Weight and renal function Weight and leukocytosis Height and weight Age and weight

Weight and renal function

A client is being treated for pharyngitis with penicillin V. This nurse caring for this client needs to explain the proper way to take this medication. What would be the best instruction? -You will need to take the medication every 6 hours, evenly spaced during the day. -Take the medication until the symptoms start to resolve. -You will need to take the medication once per day. -You will need to take the medication until it is gone.

You will need to take the medication every 6 hours, evenly spaced during the day.

Synergistically

a combo with other antibiotics to reach therapeutic effect

resistance

ability of pathogens over time to adapt to an anti-infective to produce cells that are no longer affected by a particular drug

Cephalosporins: contraindications

allergies to penicillin

Sulfonamides: contraindications

allergy to sulfonylureas or thiazide diuretics

A client is diagnosed with an infection attributable to the gram (-) microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism? aminoglycoside aminopenicillin GABA analog antifungal

aminoglycoside

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? antihypertensives oral contraceptives antacids antidiabetic agents

antacids

Aminoglycosides

antibiotics used to treat infections caused by gram-negative aerobic bacilli

A client is being treated for a UTI with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? assessing for diabetes mellitus assessing for hypertension assessing for the presence of asthma assessing for renal insufficiency

assessing for renal insufficiency

A client being treated with an oral penicillin should be encouraged to administer the medication on which schedule to best achieve a therapeutic effect? (Select all that apply.) upon rising in the am at regular intervals around the clock at bedtime with meals

at regular intervals around the clock

Monobactam drug example

aztreonam (Azactam)

Aminoglycosides: static or cidal

bactericidal

Fluoroquinolones: cidal or static

bactericidal

Ketolides: static or cidal

bactericidal

Penicillins & Penicillinase-Resistant Antibiotics: cidal or static?

bactericidal

Drugs that destroy bacteria are known as which type of drug? bacteriostatic bacteriophage bacteriocidal bacteriostationary

bacteriocidal

Kernicterus

billirubin in CSF

prophylaxis

by self

It is really important to educate patients who are on a antibiotic that it will ______________ their birth control.

cancel out

Gram-negative

cell wall loses a stain or is decolorized by alcohol

Gram-positive

cell wall retains a stain (Gram's stain) or resists decolorization with alcohol on culture and sensitivity test

antibiotics

chemicals that inhibit specific bacteria

Carbapenems: cidal or static?

cidal

Lipoglycopeptides cidal or static?

cidal

Goal of antibiotic therapy

decrease population of invading bacteria to point where human immune system can effectively deal with invader

Aerobic

depend on O2 for survival

Culture testing

determine which antibiotic is going to be effective in treatment

Sensitivity testing

determines which antibiotic to which the organisms will be most sensitive to

Anaerobic

do not use O2

A client, hospitalized with active TB, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?

drug-resistant TB

sensitivity testing

evaluation of pathogens obtained in a culture to determine the anti-infectives to which the organisms are sensitive and which agent would be appropriate for treatment of a particular infection

Macrolides contraindications

eye infections

sample of the bacteria examples

from sputum, cell scrapings, urine

Ciprofloxacin must be _________ if IV

given alone

Any drug can cause a ___________ reaction.

hypersensitivity reaction

The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which? increase sodium intake. restrict fluid intake. restrict sodium intake. increase fluid intake.

increase fluid intake

superinfection

infections that occur when opportunistic pathogens that were kept in check by the "normal" bacteria have the opportunity to invade tissues and cause infections because the normal flora bacteria have been destroyed by antibiotic therapy

Ototoxicity

injury to auditory nerve

What adverse effect would most likely necessitate discontinuing treatment with isoniazid? pruritus jaundice persistant nausea alopecia

jaundice

Bacteriostationary...

keeps the bacteria in place, and bacteriophage uses enzymatic substances to destroy the bacteria

nephrotoxicity

kidney damage

peak

med in bloodstream at maximum point

Ketolides: indications

mild to moderate community-acquired pneumonia

A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how? at bedtime only. on an empty stomach. with milk or fruit juice. take with a meal.

on an empty stomach

Antimycobacterials: side effects

orange urine, saliva, sweat, tears with rifampin

Aminoglycosides: Side Effects

ototoxicity and nephrotoxicity

Carbapenems: Contraindications

patients younger than 18

Document what kind of reaction/sensitivity they have to ___________ when giving Penicillins & Penicillinase-Resistant Antibiotics.

penicillin

Carbapenems: Cautions

pregnancy renal dysfunction

Cephalosporins: MOA

prevent the bacteria from biosynthesizing the framework of the cell walls

Antimycobacterials: MOA

prevents synthesis of mycolic acid in the cell wall

Bacteriostatic

prevents; a biological or chemical agent that stops bacteria from reproducing

spectrum

range of bacteria against which an antibiotic is effective

Fluoroquinolones: cautions

renal dysfunction

Gram-positive often associated with infections of ___________

respiratory tract

culture

sample of the bacteria be grown in a lab to determine the species of bacteria that causes an infection

Lincosamides indications

severe infections when a less toxic antibiotic can not be used

bactericidal

substance that causes the death of bacteria, usually by interfering with cell membrane stability or with proteins or enzymes necessary to maintain the cellular integrity of the bacteria

bacteriostatic

substance that prevents the replication of bacteria, usually by interfering with proteins or enzyme systems necessary for reproduction of the bacteria

Sulfonamides: don't give to patients allergic to what?

sulfa

antibiotics may be given:

synergistically or prophylaxis

Bactericidal

targets; kills bacteria

Ketolides: example drug

telithromycin (Ketek)

selective toxicity

the ability to affect certain proteins or enzyme systems that are used by the infecting organism but not by human cells

synergistically

together

prophylaxis

treatment to prevent an infection before it occurs, as in the use of antibiotics to prevent bacterial endocarditis in high-risk patients or anti-protozoals to prevent malaria

Oxazolidinones drug-food interactions

tyramine containing foods

Gram-negative often associated with infections of _____________________________

urinary and GI tract

Lincosamides MOA

-Bind to the subunit of the ribosome, interfering with protein synthesis. -Prevents cell division or cell death depending on the concentration of the drug.

Fluoroquinolones: nursing considerations

-C&S before therapy starts -Do not take with food -Do not take with iron preps, sulcrafate, mineral supplements, or antacids -Can take with Probenecid

Aminoglycosides: Nursing Considerations

-Check renal function -I%Os -Take full course of meds -Monitor peak & trough

Monobactam side effects

-Elevated hepatic enzymes -Injection site irritation -Anaphylaxis

Cephalosporins: cautions

-Hepatic & renal impairment -pregnancy/lactation

Lincosamides cautions

-Hepatic or renal impairment -Pregnancy & lactation

Monobactam contraindications

-History of allergy to PCN or cephalosporins -Renal and hepatic impairment -Pregnancy & lactation

How to choose the right antibiotic for treatment:

-Identify causative organism from a culture -Sensitivity testing

Antimycobacterials: nursing considerations

-Monitor for hepatic side effects -Monitor for numbness and tingling of extremities -Collect sputum specimens -Checking for acid fast bacteria -Establish infection control measures -Establish therapeutic environment to ensure adequate rest, nutrition, hydration, and relaxation -To be taken 1 hr before meals or 2 hrs after

Carbapenems: Nursing Considerations

-Monitor periodic liver and kidney function. -Determine history of hypersensitivity reactions to penicillins -Monitor for seizures.

Penicillins & Penicillinase-Resistant Antibiotics

-PCN was first antibiotic introduced for clinical use -Later versions of PCN were made to decrease adverse effects & act on resistant bacteria

Penicillins & Penicillinase-Resistant Antibiotics: Indications

-PNA -meningitis -infectious endocarditis -pharyngitis -syphilis -Prophylaxis against bacterial endocarditis prior to dental procedures

Lincosamides side effects

-Pain -Skin infections -Bone marrow suppression

Macrolides indications

-Pelvic Inflammatory Disease -Upper Respiratory Infections -Intestinal Amebiasis -dental work

Carbapenems: Side Effects

-Pseudomembranous colitis -Cdiff -Superinfections -seizures

Aminoglycosides: Contraindications

-Renal or hepatic disease -hearing loss -Parkinson's -active herpes -mycobacterial infections -lactation

Ketolides: cautions

-Renal or hepatic impairment -Pregnancy & lactation

Lipoglycopeptides

-Semisynthetic derivatives of vancomycin -useful against gram-positive bacteria

Ketolides: drug interactions

-Statins -pimozide -digoxin -metoprolol -rifampin -phenytoin -carbamazepine -phenobarbital -theophylline

Sulfonamides: nursing considerations

-Take with meals -Encourage fluids (need 3000 mL/day) -Monitor urine output -Good oral care

Tetracyclines: side effects

-esophageal ulceration -yellow/brown tooth discoloration -hypoplasia of tooth enamel

Fluoroquinolones: all end in what?

-floxacin

Lipoglycopeptides side effects

-foamy urine -Red man syndrome (flushing, sweating, hypotension)

Macrolides cautions

-hepatic and renal impairment -pregnancy and lactation

Oxazolidinones adverse effects

-insomnia -dry mouth -colitis -Thrombocytopenia

Sulfonamides: caution

-kidney stones -elderly

The physician has prescribed cotrimoxazole to a 1-month-old infant for an infection. The nurse knows that this medication is contraindicated because of the potential for what health problem? Hepatotoxicity Nephropathy Neuropathy Kernicterus

Kernicterus

The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body? They disrupt the normal flora of the body. They disrupt the existing bacterial infection. They decrease the infectious bacterial process. They increase the infectious bacterial process.

They disrupt the normal flora of the body.

Sulfonamides

Treat infections caused by gram-negative & gram-positive bacteria

Drugs that slow or retard the multiplication of bacteria are known as ___________.

bacteriostatic

Sulfonamides: cidal or static

bacteriostatic

Tetracyclines: cidal or static

bacteriostatic

Lipoglycopeptides all end in what?

-vancin

Sulfonamides: drug interactions

-warfarin -phenytoin -sulfonylurea -oral hypoglycemics -oral hormonal contraception -cyclosporine

trough

-when med is at lowest point -right before med is given

Oxazolidinones all end in what?

-zolid

Sulfonamides: MOA

block para-aminobenzoic acid to prevent the synthesis of folic acid in bacteria that synthesize their own folates for the production of RNA and DNA

A 9-year-old client has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the client's admission orders and notes that IV demeclocycline has been prescribed. After beginning this treatment, the nurse should confirm the results of what lab test? mean corpuscular volume (MCV) blood urea nitrogen (BUN) bilirubin d-dimer

blood urea nitrogen (BUN)

spectrum examples

broad-spectrum antibiotics are effective against a wide range of bacteria; narrow-spectrum antibiotics are effective only against very selective bacteria

Lipoglycopeptides MOA

-Inhibit cell wall synthesis by interfering with the polymerization and cross-linking of peptidoglycans. -Bind to bacterial membrane and disrupt the membrane barrier function causing cell death.

Oxazolidinones MOA

-Interfere with protein synthesis on the bacterial ribosome -act as MAOIs

Carbapenems: Indications

-Intra-abdominal (peritonitis) -UTI -skin infections -bone infections -joint infections -gyno infections -pneumonia

Penicillins & Penicillinase-Resistant Antibiotics: nursing considerations

-MUST check for hypersensitivity -Take 1 hr before or 2 hrs after meals with 8 oz of water -Cross allergy with cephalosporins -Monitor liver functions & renal functions

Tetracyclines: nursing considerations

-Take on empty stomach with 8 oz of water, 1 hour before meals or 2 hours after meals -Do not take with antacids, laxatives containing magnesium, milk, calcium, or iron -Monitor renal function -Avoid sunlight -use sunscreen

Cephalosporins: nursing considerations

-Take with food -Cross allergy with penicillin -Avoid ETOH -Obtain C&S before 1st dose -May give false-positive for proteinuria and glycosuria

Penicillins & Penicillinase-Resistant Antibiotics: drug interactions

-Tetracyclines -parenteral aminoglycosides -PO contraceptives

Sulfonamides: indications

-Trachoma -Nocardiosis -UTIs -STIs -Ulcerative colitis -RA

Fluoroquinolones: Indications

-Urinary tract, respiratory tract, GI, skin infections -Prevention of anthrax -Typhoid fever

Monobactam indications

-Urinary tract, skin, intra-abdominal, and gynecological infections -septicemia

Oxazolidinones indications

-VRE -MRSA -Penicillin-resistant pneumococci -Diabetic foot infections -Pneumonia -Skin and skin structure infections

Aminoglycosides: all end in...

-acin

Tetracyclines: contraindications

-allergy to tartrazine -ocular infections

Cephalosporins: side effects

-anorexia -Superinfections -Pseudomembranous colitis -Pain (IM injection) -Thrombophlebitis (IV infusion) -Bleeding

Sulfonamides: all end in what?

-azine -azole

Cephalosporins: all begin with what?

-cef -ceph

Penicillins & Penicillinase-Resistant Antibiotics: all end in what?

-cillin

Tetracyclines: all end in what?

-cycline

Lincosamides all end in...

-mycin

Tetracyclines: If patient can not sit up for 30 minutes after taking med, then... Discontinue if patient is having...

-patient does not need to take this med -difficulty swallowing or painful swallowing

Carbapenems: all end in what?

-penem

Fluoroquinolones: contraindications

-pregnancy -lactation -uncomplicated infections

Antimycobacterials: contraindications

-renal & hepatic failure -pregnancy

Aminoglycosides: Indications

-serious infections susceptible to penicillin when penicillin is contraindicated -E-coli -Klebsiella pneumoniae -Proteus mirabilis -Pseudomonas aeruginosa

Penicillins & Penicillinase-Resistant Antibiotics: side effects

-stomatitis -gastritis -sore mouth -superinfections -hypersensitivity

Ketolides: side effects

-taste alterations -colitis -Superinfections -Hypersensitivity -Anaphylaxis

Macrolides all end in what?

-thromycin