PrepU Pharm Assignment 3
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response?
"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse?
"You may be experiencing an additional infection. I will discuss with your physician."
Place the following events relating to the mechanism of action of daptomycin (Cubicin) in order from what happens first to last.
-Binds to the bacterial membrane -Interferes with the integrity of the cell wall -Rapid depolarization -Inhibition of protein, DNA, and RNA synthesis -Cell death
A patient has recently been diagnosed with acute and uncomplicated cystitis, for which she received ciprofloxacin (Cipro) 250 mg PO BID x 7 days. When counseling this client about taking the medication, which should the nurse include? (Select all that apply.)
-You will need to use a backup method of birth control if you are taking oral contraceptives. -Antacids can interfere with the absorption of Cipro.
The physician has ordered levofloxacin 500 mg orally. The drug is available in 250 mg tablets. The nurse administers how many tablets?
2
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is mixed in a syringe for an IV pump as a solution of 250 mg/15 mL. How many mL should be in the syringe?
45
A patient not known to have any allergies and not taking any other medications presents to the clinic with an uncomplicated urinary tract infection. Which of the following medications would most likely be given to this patient?
A second-generation fluoroquinolone
A nurse knows that when administering intravenous (IV) carbapenem, the highest priority action after administration is:
Assessing the IV site
Fluoroquinolones treat infection by which of the following effects? (Choose one)
Bactericidal
Ciprofloxacin (Cipro) can be used to treat which of the following?
Both gram-positive bacteria and gram-negative bacteria
The client has been started on levofloxacin (Levaquin) for a respiratory infection. The client is now experiencing sores in his mouth. The nurse suspects this is due to what type of superinfection?
Candidiasis
The client is complaining of vaginal itching after five days of fluoroquinolone therapy. The nurse suspects which of the following?
Candidiasis
A patient has been diagnosed with a community-acquired skin infection and has been prescribed linezolid (Zyvox). Which of the following foods should not be eaten during the administration of this medication?
Cheddar cheese
Which of the following medications are available in ophthalmic form? Select all that apply.
Ciprofloxacin Norfloxacin Ofloxacin
Which of the following medications are associated with QT interval prolongation on electrocardiogram (ECG)? Select all that apply.
Ciprofloxacin Ofloxacin Levofloxacin Moxifloxacin
A patient with a gram negative bacteria infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which of the following laboratory tests, if ordered, are obtained before the first dose of fluoroquinolones is administered to the patient?
Culture and sensitivity test
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?
Decreased absorption
A client who takes anticoagulants for atrial fibrillation is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs requires frequent assessment for which of the following?
Decreased clotting
The nurse should advise the client which of the following in regards to the administration of fluoroquinolones?
Do not take antacids while taking fluoroquinolones
A client is prescribed ciprofloxacin for an acute sinus infection. This drug belongs to what category of anti-infective medications?
Fluoroquinolones
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
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
Which of the following represents the mechanism of action of fluoroquinolones?
Interference with the synthesis of bacterial DNA.
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 of the following ways?
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 young lifeguard has been prescribed moxifloxacin (Avelox). The nurse focuses education on which adverse reaction?
Photosensitivity
A patient who has been receiving intravenous (IV) vancomycin begins to report neck and back pain as well as feeling hot and having chills. The nurse assesses the patient and notices that the neck is red. The patient's temperature is 102 degrees F; BP is 86/58. This patient is showing signs and symptoms of which of the following syndromes?
Red-man syndrome
Common, potentially serious, adverse effects of antibiotic drugs include:
Skin rash
A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?
Take precautions to prevent photosensitivity.
The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
The client has developed a superinfection.
A patient with cardiac disease and taking plavix is admitted with a lower respiratory infection. The physician starts the patient on levaquin 500 mg IV every 24 hours. About what should the nurse be concerned?
The patient may have an increased risk for bleeding.
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
The use of ciprofloxacin is contraindicated in pregnancy.
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 microbial flora of the body.
A patient is prescribed ciprofloxacin 500 mg po twice a day. The nurse notes that the ciprofloxacin is scheduled to be given with breakfast. The nurse correctly administers ciprofloxacin _____
Twice daily po, 2 hours after the meal
The nurse is taking a health history from a newly admitted patient with a urinary tract infection (UTI). When the nurse asks about allergies, the patient reports allergies to cephalosporins and penicillin. What other class of drugs should this patient avoid?
carbapenems
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include to:
increase fluid intake.
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 physician is going to start a patient who has just been diagnosed with gonorrhea on an anti-infective regimen. When questioned about allergies, the patient reports allergy to penicillin, cephalosporins, and probenecid. The treatment of choice for this patient will be what anti-infective?
spectinomycin