PN119 PrepU Chapter 7

A patient being discharged from the hospital is ordered an oral-suspension cephalosporin. When the nurse instructs the patient to store the bottle in the refrigerator, the patient asks, "Why does that matter?" The nurse's best response would be which of the following?

"Drugs that require refrigeration lose potency if kept at room temperature."

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 postoperative patient is ordered Keflex 250 mg every 6 hours for 5 days. How much Keflex will the patient receive in a 24-hour period?

1 Gram

The nurse is giving instructions to a patient who is being discharged home with a prescription for augmentin. The nurse informs the patient that the best time to take this medication is which of the following?

1 hour before meals and 2 hours after a meal

A patient has been started on augmentin 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

Penicillins may trigger an anaphylactic reaction in some patients. During what period following injection of a penicillin is anaphylaxis most likely to occur?

30 minutes

A patient has been recommended 500 mg of amoxicillin and potassium clavulanate acid (Augmentin) every 12 hours. The available drug is in the form of a 125 mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each time.

4

A patient has been prescribed 200mg of cefpodoxime every 12 hours. On hand are 25-milligram tablets. To meet the prescribed dose, the nurse administers ___________ tablets at each dosage.

8

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.

The physician has ordered penicillin V for a patient. What should the nurse instruct to take with the medication?

A full glass of water

The client calls the clinic to report the 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 that same day. What has this client consumed that has caused this reaction?

Alcohol

A nurse is preparing to give a patient an initial dose of a penicillin preparation. What is the first action the nurse should take?

Ask the patient if he or she has ever had an allergic reaction to a penicillin.

A 67-year old client with a history of chronic illness is undergoing penicillin therapy. Client age and health history indicate an increased susceptibility to pseudomembranous colitis. Which symptoms should a nurse monitor for when caring for this client? Select all that apply.

Bloody diarrhea Rectal bleeding Abdominal cramping

A patient has a history of a life-threatening anaphylactic reaction to penicillin G. Which of the following medications should not be administered to this patient?

Cefadroxil (Duricef)

A patient is diagnosed with febrile neutropenia. Which of the following medications is most effective in treating this patient?

Cefepime hydrochloride (Maxipime)

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component of bacterial development do these drugs affect?

Cell wall synthesis

Your client is being prepared for surgery. His health care provider has indicated that he will order antibiotics as prophylaxis. Which of the following medications would you anticipate being ordered?

Cephalosporin

What symptoms should lead the nurse to suspect that a client receiving a cefuroxime ingested alcohol during treatment? Select all that apply.

Chest pain Throbbing headache Dyspnea

A patient with a probable urinary tract infection is admitted to the hospital. The first thing the nurse should do before administering the ordered cephalosporin is:

Collect urine for testing culture and sensitivity.

Natural penicillins have been available since 1941 to treat infections. This length of time has caused significant problems for patients. The nurse identifies this problem as which of the following?

Drug-resistant strains of microorganisms have developed.

Penicillinase causes bacterial resistance by which of the following mechanisms? (Choose one)

Enzymatic inactivation of the penicillin

How often during on going assessment of clients taking cephalosporins the nurse inspects the skin for redness, rash, or lesions that appear as red wheals or blisters? (Choose one)

Every 4 hours

Which of the following classes of penicillins are used to treat Pseudomonas? (Choose one)

Extended spectrum penicillins

The nurse is taking a pharmacolgy course to increase her knowledge about how medications work. When studying the different types of penicillins, the nurse learns that only one group destroys the bacteria pseudomonas. It is which group?

Extended-spectrum penicillins

Which of the following herbs has some evidence that supports its use to treat diarrhea caused by bacteria or intestinal parasites? (Choose one)

Goldenseal

A patient who has undergone surgery of the urinary tract is administered cephalosporins to prevent infections. When assessing the patient on the day after the surgery, the nurse notices that he has an elevated temperature. Which of the following nursing interventions would be most appropriate in this case?

Inform the primary healthcare provider

A patient is administered penicillin V orally for a strep throat. What is the action of this medication?

It inhibits cell wall synthesis.

Some combination antibacterial drugs consist of a penicillin and a beta-lactamase inhibitor. What is the primary purpose of a beta-lactamase inhibitor in one of these drugs?

It protects the penicillin.

An older adult is to receive a low dose of a cephalosporin for an infection. The nurse realizes that this client has age-related diminished renal function. What should the nurse do?

Monitor blood creatinine levels.

Mr. Green, age 64, is admitted to your unit with exacerbation of chronic heart failure and pneumonia. Mr. Green is started on cefixime. On the third hospital day, you are assessing Mr. Green and note white patches in his mouth, and he is complaining of diarrhea. What would be the most likely reason for these symptoms?

Mr. Green has developed a superinfection because the antibiotic has destroyed the normal bacterial flora in his body.

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the patient reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity

The nurse is caring for a client age 44 years who takes furosemide (Lasix) on a daily basis and will be taking a ceftriaxone (Rocephin) for an infection. The nurse expects that the health care provider will do what with the dosage of medication for this client?

Order a decreased dosage

Your client has been diagnosed with streptococcal pharyngitis. Which of the following would you anticipate being ordered?

Penicillin G

A patient has a history of rheumatic fever. Which of the following medications should be administered as prophylaxis for rheumatic fever?

Penicillin G benzathine (Bicillin LA)

Unasyn is administered to a patient with Staphylococcus aureus. What type of antiinfective is Unasyn?

Penicillin-beta-lactamase inhibitor combination

Cephalosporins are structurally and chemically related to which classes of antibiotics? (Choose one)

Penicillins

A patient with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this patient to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client?

These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.

Cephalosporins are usually bactericidal. True or false?

True

T/F: When checking a patient's allergy history, the nurse should assume that if a patient is allergic to penicillins, he or she likely is also allergic to cephalosporins.

True

T/F: When checking a patient's allergy history, the nurse should assume that if a patient is allergic to penicillins, he or she likely is also allergic to cephalosporins?

True

The natural penicillins have a fairly narrow-spectrum of activity. This statement is which of the following?

True

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 birth control 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 severely ill, immunocomprimised patients in intensive care, transplant, and some cancer treatment units. This is which of the following?

VRE

Culture and sensitivity testing of a client's urine sample reveals a bacterium that is susceptible to cephalosporins. What medication would be most likely for the nurse to administer?

`Cefaclor

MRSA can best be defined as which of the following?

a bacteria resistant to certain antibiotics

A nurse is caring for a patient who is receiving cephalosporin. Which histories will a nurse obtain as part of the preadministration assessment? Select all that apply.

allergy history drug history surgical treatment history

A patient has just received a first dose of intravenous nafcillin when he immediately begins to have difficulty breathing and loses consciousness. The nurse takes the patient's vital signs: blood pressure is 88/50 with a pulse oxygenation of 88%.W hat should the nurse suspect?

anaphylactic shock

The concentration of any drug in the body is referred to as which of the following?

blood level

Unlike penicillin, most cephalosporins can be taken with food to prevent gastric upset. Which of the following is the only cephalosporin that the nurse would advise NOT to take with food?

ceftibuten

A patient is scheduled for a bowel resection. During the perioperative period, which of the following medications should the nurse anticipate the patient will be given?

cephalosporins

Cephalosporins are structurally and chemically related to penicillin and are divided into which of the following classes? (Select all that apply.)

first-generation drugs second-genration drugs third-generation drugs fourth-generation drugs

A client is prescribed cefazolin for a sinus infection. After administration of the first dose of the medication, the client reports itching. The nursing assessment reveals a rash over the client's torso; the client has a history of allergic reaction to penicillin. The client:

is experiencing an allergic reaction caused by a cross-sensitivity reaction.

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 patient concerning her the use of

oral contraceptives.

The nursing instructor is teaching the students about the many different gastrointestinal adverse reactions to penicillin. What other reactions does the nurse need to include? (Select all that apply.)

pain at the injection site irritation at the vein phlebitis

The nursing student is learning about the different type of penicillins and is trying to identify them according to both generic and trade names. She shows understanding of ampicillin when she correctly identifies its trade name as which of the following?

principen

The nurse knows that superinfections are a concern for patients who have been taking oral penicillins. Which of the following is one of the more common superinfections?

pseudomembranous colitis

The nurse is aware that drug resistance has significantly increased. In which of the following situations would one expect to find an issue with drug resistance?

residents in a long-term care facility

A 34-year-old female patient is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The patient reports gastrointestinal distress. The nurse will encourage the patient to

take the drug with food.