Chapter 91: Miscellaneous Antibacterial Drugs: Fluoroquinolones, Metronidazole, Daptomycin, Rifampin, Rifaximin, Bacitracin, and Polymyxins

The healthcare provider orders levofloxacin [Levaquin] 500 mg PO every day for 7 days. The available medication is levofloxacin 250-mg tablets. How many tablets should the patient take each day? 0.5 tablet 1 tablet 1.5 tablets 2 tablets

2 tablets

The nurse notices tan lines around the arms of a female patient who is taking levofloxacin [Levaquin]. Which action should the nurse take? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Advise the patient to avoid sun exposure and wear sun screen when outside. Discontinue the medication.

Advise the patient to avoid sun exposure and wear sun screen when outside.

The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients? Metronidazole [Flagyl] Rifampin [Rifadin] Ciprofloxacin [Cipro] Daptomycin [Cubicin]

Ciprofloxacin [Cipro]

Which approach should a nurse take when administering an oral dose of levofloxacin [Levaquin]? Give the medication with or without food. Administer the drug with an oral dose of a magnesium-based antacid. Premedicate the patient with diphenhydramine [Benadryl]. Administer the drug with milk products.

Give the medication with or without food.

After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant? The patient takes antacids on a daily basis. The medication was stored in a cool, dry area. The patient did not use sunscreen while taking the ciprofloxacin [Cipro]. The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.

The patient takes antacids on a daily basis.

The nurse identifies rifampin as useful in the treatment of which disorders? (Select all that apply.) Tuberculosis Active meningococcal infection Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae C. difficile infection

Tuberculosis Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae

Which antibiotics may be administered topically? (Select all that apply.) a. Bacitracin b. Daptomycin c. Ofloxacin d. Polymyxin B e. Rifampin

a. Bacitracin d. Polymyxin B

Which fluoroquinolone antibiotics may be administered to children? (Select all that apply.) a. Ciprofloxacin [Cipro] b. Levofloxacin [Levaquin] c. Moxifloxacin [Avelox] d. Norfloxacin [Noroxin] e. Ofloxacin

a. Ciprofloxacin [Cipro] b. Levofloxacin [Levaquin]

A nurse is preparing to administer an antibiotic to a patient with methicillin-resistant Staphylococcus aureus (MRSA). The nurse would expect the healthcare provider to order which antibiotic? a. Daptomycin [Cubicin] b. Levofloxacin [Levaquin] c. Norfloxacin [Noroxin] d. Ciprofloxacin [Cipro]

a. Daptomycin [Cubicin]

A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: a. add metronidazole [Flagyl]. b. increase the dose of ciprofloxacin. c. restrict dairy products. d. switch to gemifloxacin.

a. add metronidazole [Flagyl].

A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching? a. "I may have abdominal pain and nausea, but these are usually mild." b. "I should take this medication with food or milk to improve absorption." c. "I should stop taking the medication immediately if I experience heel pain." d. "I will need to use sunscreen every time I go outdoors."

b. "I should take this medication with food or milk to improve absorption."

A nursing student is caring for a patient with community-acquired pneumonia (CAP) who also has a methicillin-resistant Staphylococcus aureus (MRSA) skin infection. The prescriber has ordered daptomycin [Cubicin]. The nurse encourages the student to approach the provider to request a different antibiotic because of which facts about daptomycin? (Select all that apply.) a. It causes significant renal impairment. b. It is approved only for bloodstream and skin infections. c. It increases the risk of serious cardiorespiratory events. d. It is more likely to produce resistant strains of bacteria. e. It is not effective against MRSA infections.

b. It is approved only for bloodstream and skin infections. c. It increases the risk of serious cardiorespiratory events.

The nurse is caring for a patient who will begin receiving intravenous ciprofloxacin [Cipro] to treat pyelonephritis. The nurse learns that the patient has a history of myasthenia gravis. Which action by the nurse is correct? a. Administer the ciprofloxacin and monitor the patient for signs of muscle weakness. b. Ask the provider whether the ciprofloxacin can be given orally. c. Request an order for concurrent administration of metronidazole [Flagyl]. d. Suggest that the provider order a different antibiotic for this patient.

d. Suggest that the provider order a different antibiotic for this patient.

A nurse is preparing to administer oral ofloxacin to a patient. While taking the patient's medication history, the nurse learns that the patient takes warfarin and theophylline. The correct action by the nurse is to request an order to: a. reduce the dose of ofloxacin. b. increase the dose of ofloxacin. c. increase the dose of theophylline. d. monitor coagulation levels.

d. monitor coagulation levels.

A provider orders intravenous moxifloxacin [Avelox] for a patient who has sinusitis. Before administering the drug, the nurse will review this patient's chart for: a. a history of asthma. b. concurrent use of digoxin. c. concurrent use of warfarin. d. recent serum electrolyte levels.

d. recent serum electrolyte levels.

A patient who is taking calcium supplements receives a prescription for ciprofloxacin [Cipro] for a urinary tract infection. The nurse will teach this patient to: a. consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. b. stop taking the calcium supplements while taking the ciprofloxacin. c. take the two medications together to increase the absorption of both. d. take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

d. take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Slow the running pace and walk more. Discontinue the medication, because severe damage can result.

Discontinue the medication, because severe damage can result.

A patient taking gemifloxacin develops a rash. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Cut the dose of medication in half. Discontinue the medication.

Discontinue the medication.

A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse anticipates administration of which antibiotic if a stool sample tests positive for Clostridium difficile? Rifaximin [Xifaxan] Metronidazole [Flagyl] Daptomycin [Cubicin] Gemifloxacin [Factive]

Metronidazole [Flagyl]

A patient is taking daptomycin [Cubicin]. The nurse should obtain a creatine phosphokinase (CPK) level when the patient shows what? Increased urination and urinary urgency Muscle pain and weakness Abdominal bloating and diarrhea Headache and visual disturbances

Muscle pain and weakness

A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do? a. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms. b. Instruct the patient to exercise the right foot and ankle to minimize the pain. c. Question the patient about the consumption of milk and any other dairy products. d. Request an order to increase this patient's dose of glucocorticoids.

a. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.