Pharm Ch 19

The nurse is assessing a young female client who is prescribed an aminoglycoside to treat a gram-negative bacterial infection. Which question will the nurse ask the client before providing a dose of the medication?

"Are you pregnant?"

You are preparing to discharge a patient who is taking ciprofloxacin. What guidance would you offer this patient to prevent crystalluria?

"Drink at least 2 liters of fluids per day."

The client has been diagnosed with a serious infection caused by gram-negative aerobic bacilli. The client has been prescribed IV gentamicin. What statement by the client should the nurse follow up most promptly?

"I feel like I'm having trouble hearing the last little while."

A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?

"I will only drink enough water to swallow the drug."

The nurse is evaluating the medical records of several clients and note some are receiving both fluoroquinolone and corticosteroid therapy. The nurse concludes which client is at the greatest risk for tendonitis?

72-year-old male

A client with a severe infection has an order for IV gentamicin and IV penicillin. How will the nurse administer these medications?

Administer the gentamicin IV and wait 1 hour and administer the penicillin.

The nurse examines the medication history of a client scheduled to receive moxifloxacin. The nurse should contact the health care provider before giving this drug if the client is already taking which drug? Select all that apply.

Amiodarone Sotalol Procainamide

A client develops pseudomembranous colitis secondary to fluoroquinolone therapy. The nurse anticipates the bowel culture will grow which organism?

C. difficile

Which of the following drugs is likely to be administered as a first-line treatment for anthrax exposure?

Ciprofloxacin

Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order?

Culture and sensitivity

The nursing student correctly identifies the class of drugs that exerts their bactericidal effect by interfering with the synthesis of bacterial DNA, thus preventing cell reproduction and leading to death of the bacteria, as which of the following groups?

Fluoroquinolones

Which of the following classes of antibiotics is a direct inhibitor of DNA synthesis in bacteria?

Fluoroquinolones

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?

Gentamicin

Which of the following drugs would be classified as an aminoglycoside?

Gentamicin

A 60-year-old male client with a diagnosis of bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in the client's condition and the effect of the drug treatment on his blood cultures. During morning care, the client has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this client?

Hold the next scheduled dose of gentamicin until the health care provider has been consulted.

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?

Ototoxicity and nephrotoxicity

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

Photosensitivity

The health care provider orders an aminoglycoside for a ventilator-dependent client who is admitted to the critical care unit. The client's current diagnoses include respiratory arrest, type 2 diabetes, hepatitis C, and chronic obstructive pulmonary disease. Which statement indicates the risk of using this class of medication in this client?

Risk for hepatic impairment is not significant, because the drug is excreted through the kidneys.

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 chronic renal failure

A client who routinely takes antacids has been prescribed a oral fluoroquinolone for an infection. The nurse instructs the client to take the antibiotic at which times?

Two to four hours before, or six to eight hours after the antacid

Fluoroquinolones are used to treat which infection(s)? Select all that apply.

Urinary tract infections Respiratory tract infections Skin infections

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?

antacids

When describing the action of fluoroquinolones to treat infection to a group of nursing students, which would the instructor include?

bactericidal

An older adult client is prescribed intravenous ciprofloxacin for the treatment of a urinary tract infection. What nursing assessment should the nurse prioritize to identify potential adverse effects?

blood glucose monitoring

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

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

increase fluid intake.

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example?

metronidazole

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?

oral (PO)

A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to

take the vitamins at least 2 hours before or after taking ciprofloxacin.

The ICU nurse is caring for a patient who is receiving a fluoroquinolone. The nurse knows that which of the following decreases absorption of the fluoroquinolone if given concomitantly?

Enteral feedings

The client has been prescribed a drug that must be taken on an empty stomach. The nurse knows that to administer a medication on an empty stomach, it is given in which way?

One hour prior to a meal or two hours after the meal

When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route?

Oral

A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order?

Peak and trough serum levels

The nurse is caring for a child weighing 30 kg. The healthcare provider orders gentamicin 100 mg IV three times per day. The recommended dosage range is 6 to 7.5 mg/kg/day. What action should the nurse take?

Question the prescriber about the dosage of the medication.

The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize?

Renal function

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

Renal function tests

The nurse is explaining to a client the proper way to take extended-release fluoroquinolone. Which instruction would be most important to include in the client's teaching plan?

To swallow the medication whole

A local bioterrorism medical team is responding to a possible anthrax attack. The team is instructed that a fluoroquinolone may be used to treat exposure to anthrax. The nurse should prepare to administer what antibiotic?

ciprofloxacin

A client has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause which?

ototoxicity or nephrotoxicity.