239 Ch 19: Aminoglycosides and Fluoroquinolones PREP U

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."

A nurse has been performing vigilant assessments of a patient who is receiving doses of intravenous gentamicin, each over 30 minutes. A blood sample for peak gentamicin levels should be drawn

30 minutes after the drug has finished infusing.

The nurse instructs the client who is taking oral ciprofloxacin to avoid which food while taking this medication?

Cheese

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

Ciprofloxacin

What pharmacologic principle causes nephrotoxicity when gentamicin is administered?

Distribution

A client is prescribed ciprofloxacin for an acute sinus infection. The nurse knows that this anti-infective medication belongs to which drug category?

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

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

Gentamicin

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

Ototoxicity and nephrotoxicity

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

PO

A client scheduled to undergo major abdominal surgery has been prescribed preoperative neomycin. Neomycin is used preoperatively for what reason?

Suppress intestinal bacteria.

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.

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 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 client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

The use of ciprofloxacin is contraindicated in pregnancy.

The nurse should notify the health care provider immediately if a client has this possible sign of serious neurotoxicity when a client is receiving an aminoglycoside.

Tremors Circumoral paresthesia Numbness or tingling of the skin (peripheral paresthesia) Muscle twitching or weakness

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 action would the instructor most likely include?

bactericidal

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 nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which action would the instructor most likely include?

interfering with DNA synthesis in the bacterial cell

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

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

photosensitivity

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.

What symptom should the nurse expect to find if the client begins to exhibit signs of ototoxicity?

tinnitus

A client is prescribed ciprofloxacin 500 mg PO twice a day. When would the nurse most likely administer the drug?

twice daily PO, 2 hours after the meal

The nurse is caring for a client who is receiving amikacin for the treatment of a serious Staphylococcus aureusinfection. What assessment should the nurse prioritize?

urine output and creatinine clearance

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.

Which of the following signs should the nurse monitor a client for that would indicate nephrotoxicity from an aminoglycoside?

Proteinuria Hematuria Decreased urine output Increased serum creatinine