Antibiotics

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

Ask the client if there is a history allergy to a penicillin.

A client with diabetes is ordered a cephalosporin to treat a recurring infection. The client is taking insulin and reports controlling the blood glucose level by monitoring it with urine stips and adjusting doses of insulin accordingly. What instructions should the nurse tell this client?

Cephalosporin may interfere with accurate test results.

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

The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug?

Diarrhea and nausea

The male client who had surgery 3 days ago is discharged home after completing his perioperative regimen of cefotetan. A few hours after being home, he drinks a beer. Approximately 5 hours later, the client becomes flushed and nauseated, reports throbbing in the head and neck, begins to sweat, and becomes hypotensive. The client is <b>most</b> likely experiencing what reaction?

Disulfiram-like

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

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

How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media?

It extends the spectrum of antibacterial activity of penicillin.

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

Penicillin G

Cephalosporins are structurally and chemically related to which classes of antibiotics?

Penicillins

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 the severely ill, immunocomprimised clients in intensive care, transplant, and some cancer treatment units. This is which?

VRE

The client has a severe infection in the leg from a boating accident. A diagnosis has been made of the presence of MRSA. MRSA can best be defined as which?

a bacteria resistant to antibiotics

A disulfiram-like reaction may occur if which substance is consumed within 72 hours after administration of certain cephalosporins?

alcohol

A nurse is caring for a client 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 group of students are separating the various penicillins into their groups. Which drug will the students indicate as an example of an aminopenicillin?

amoxicillin

A client diagnosed with infective endocarditis would be most effectively treated with which medication?

ampicillin

Which is the drug of choice for surgical prophylaxis associated with a vaginal hysterectomy?

cefazolin sodium

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

ceftibuten

The client is receiving keflex 1000 mg/day. The nurse properly identifies this drug as a:

first-generation cephalosporin.

What potential adverse reaction is most likely to develop during cefazolin therapy?

gastrointestinal upset

A client is administered a third-generation cephalosporin. The broad-spectrum agents like cephalosporins are most effective in treating which type of microorganism?

gram negative

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

methicillin-resistant Staphylococcus aureus (MRSA) infection

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 client concerning her the use of:

oral contraceptives.

The nurse has encouraged a client prescribed oral amoxicillin to take this medication with fluids but with the exception of what beverage?

orange juice

Which medication should be administered as prophylaxis for rheumatic fever?

penicillin G

The nurse is reviewing the medication history of a client who is prescribed penicillin therapy. Use of which medication would alert the nurse to the possibility of the client's increased risk for an anaphylactic reaction?

propranolol

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 client has been diagnosed with a sinus infection, and the client has been given a prescription for amoxicillin. What teaching point should the nurse make for the client?

"Take your medication every 8 hours, as it's been prescribed."

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

1 Gram

The nurse is giving instructions to a client who is being discharged home with a prescription for augmentin. The nurse informs the client that the best time to take this medication is:

1 hour before meals and 2 hours after a meal.

To maximize the prevention of an incisional infection, when will the nurse administer the prophylactic antibiotic therapy prescribed for a surgical client?

1 hour prior to the first planned skin incision

A client 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

Due to the close relationship cephalosporins have with penicillins, what percentage of clients who are allergic to penicillins are also allergic to cephalosporins? (Choose one)

10%

A client's prescription reads that the client should receive cefaclor 250 mg orally q 8 hr. The drug is available in the form of a 125-mg tablet. How many tablets should the nurse administer in order to meet the recommended dose and at what time intervals?

2 tablets every 8 hours

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

30 mins

A client has been prescribed 200 mg 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

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

A cross-sensitivity reaction.

Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?

A defective cell wall

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.

A client has been diagnosed with an infected postoperative wound, and cultures reveal methicillin-resistant Staphylococcus aureus (MRSA). The client is currently receiving intravenous cefarolin because in vitro testing indicates susceptibility. When considering the effectiveness of this client's treatment, what is the nurse's best action?

Administer the medication as prescribed and monitor for expected outcomes.

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

The nurse informs the client that most common bacterial superinfections are developed where?

Bowel

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

A client has a history of a life-threatening anaphylactic reaction to penicillin G. Which medication should not be administered to this client?

Cefadroxil

Place the following cephalosporins in the proper sequence beginning with first generation cephalosporins up to fourth generation cephalosporins.

Cefazolin Cefuroxime Cefotaxime Cefepime

A client is diagnosed with febrile neutropenia. Which medication is <b>most</b> effective in treating this client?

Cefepime hydrochloride (Maxipime)

Most cephalosporins may be taken with food except which of the following? (Choose one)

Ceftibuten

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component 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

The nurse is providing discharge education to a client who is leaving with a prescription for PO ampicillin. What should the nurse teach the client?

Discoloration of the tongue may occur but will subside when the drug is discontinued.

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?

Drink a full glass of water when taking a dose of the drug.

Natural penicillins have been available since 1941 to treat infections. What problem has developed since 1941?

Drug-resistant strains of microorganisms have developed.

A client being treated for cellulitis with a cephalosporin asks what the essential difference is between generations of this medication. The nurse should respond to the client's question based on what fact?

Each successive generation is more effective against gram-negative microorganisms.

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

A client taking a cephalosporin for a respiratory infection informs the nurse that her tongue feels funny and has white patches on it. She asks the nurse what could be wrong. The nurse informs the client that she has developed which?

Fungal superinfection

A client receiving Rocephen IV for an infection continues to run a temperature. It becomes elevated 24 hours after the client begins drug therapy. Which would be a priority nursing diagnosis for this client?

Impaired comfort

The nurse understands that bacterial resistance can result when certain bacteria produce penicillinase. What does penicillinase do?

Inactivates penicillin

A cardiac client is receiving Rocephin 1 gram IV every 12 hours postoperatively. He is currently on Diovan and Plavix. What should the nurse be concerned about with this client?

Increased risk for bleeding

Which reaction should a nurse assess for in a client who could develop a fungal superinfection in the oral cavity after being administered penicillin?

Inflamed mucous membranes

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

Inform the primary health care provider.

A nurse is caring for a client who is receiving penicillin therapy. The client has been reporting diarrhea-like symptoms, and the nurse suspects a bacterial superinfection. Which interventions would be most appropriate?

Inspect stools to confirm diarrhea.

The pharmacology instructor is explaining combination drugs to the nursing class.The instructor tells the students that the combination of a beta-lactamase inhibitor and a penicillin produces what effect?

It extends the spectrum of antibacterial activity of the penicillin.

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?

It inhibits cell wall synthesis.

The nurse is administering penicillin to a client who has strep throat. Which of the following statements accurately describe the action of penicillin?

It is effective against gram-positive organisms

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. When realizing that this client has age-related diminished renal function, what intervention should the nurse implement?

Monitor blood creatinine levels.

A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?

Nausea

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 client reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity

The nurse is caring for a 44-year-old client who takes furosemide (Lasix) on a daily basis. The physician has ordered ceftrixone (Rocephin) now for an infection. The nurse expects that the healthcare provider will do what with the dosage of ceftrixone (Rocephin) for this client?

Order a decreased dosage.

Anaphylactic shock occurs more commonly after which route of administration? (Choose one)

Parenteral

Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?

Penicillin

The nurse is caring for a client diagnosed with syphilis. The client has no known drug allergies. Which medication can the nurse expect to be ordered for this client?

Penicillin

Clients with which of the following conditions should not be administered cefprozil (Cefzil) oral suspension because it contains phenylalanine? (Choose one)

Phenylketonuria

The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration?

Phlebitis

A 36-year-old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

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

Take the drug with food.

While discussing drug combinations, including the beta-lactamase inhibitor combinations, the pharmacology instructor explains their mechanisms of action. What benefit is derived from combining a beta-lactamase inhibitor with a penicillin?

The beta-lactamase inhibitor protects the penicillin.

A hospital client has been prescribed IV ceftriaxone, a cephalosporin antibiotic. What assessment finding related to drug therapy would be of greatest concern to the nurse?

The client develops jaundice

A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?

The client has a new onset of jaundice and edema

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

The client has developed a superinfection because the antibiotic has destroyed the normal bacterial flora in his body.

An older adult client responded well to inclient treatment with a third-generation cephalosporin. After being largely symptom free for 48 hours, the client has developed a fever of 38.6°C and an elevated white cell count. What phenomenon may account for this client's current clinical presentation?

The client may be infected with microorganisms that were resistant to the cephalosporin.

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.

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

anaphylactic reaction

The nursing instructor is teaching about the many adverse reactions to penicillin, including some of the hematopoietic changes that can occur. Which of the following should the instructor include when reviewing blood cell changes? (Select all that apply.)

anemia thrombocytopenia leukopenia bone marrow depression

After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?

bactericidal

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

blood level

A 67-year-old client with a history of chronic illness is receiving penicillin therapy. The client's age and health history indicate an increased susceptibility to pseudomembranous colitis. The nurse would be alert for which finding? Select all that apply.

bloody diarrhea rectal bleeding

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

can cause allergic reactions in clients who are allergic to penicillins.

A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?

cefadroxil

A client being prepared for surgery has been prescribed prophylactic antibiotics. What medication would the nurse anticipate being prescribed?

cefazolin

Which drug is a first-generation cephalosporin used as a surgical prophylaxis?

cefazolin

After teaching a group of nursing students about the indications for use of antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the group identifies which medication as commonly prescribed to a victim after a sexual assault for infection prophylaxis?

cephalosporin

A client is scheduled for a bowel resection. During the perioperative period, which type of medication should the nurse anticipate the client will be given?

cephalosporins

Cultures reveal methicillin-susceptible Staphylococcus aureus in a client's postoperative wound. What medication should the nurse anticipate being prescribed for this client? Select all that apply.

dicloxacillin, oxacillin,nafcillin

Penicillins are most effective when used to treat what type of microorganisms?

gram-positive bacteria

Cephalosporins might interfere with the accuracy of which test?

ketone urine test

A nurse monitors a client closely for anaphylactic reactions secondary to penicillin therapy. The nurse understands that this occurs more commonly after which route of administration?

parenteral

Ampicillin-sulbactam is administered to a client with Staphylococcus aureus. What type of antiinfective is ampicillin-sulbactam?

penicillin-beta-lactamase inhibitor combination

The nursing instructor is teaching the students about different gastrointestinal adverse reactions to penicillin. What other reactions may occur with this medications administration? (Select all that apply.)

phlebitis irritation at the vein pain at the injection site

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

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

pseudomembranous colitis

The nurse has administered the first dose of a client's newly-prescribed antibiotic. What assessment finding should the nurse interpret as adverse effect that suggests a more serious concern?

rash to the face and trunk

A nurse is assessing a client who is receiving vancomycin intravenously. While the drug is being administered, the client reports a throbbing sensation in the neck and back and paresthesias. The client's blood pressure has dropped and the neck and back are erythematous. The nurse suspects which adverse finding?

red man syndrome

The nurse is aware that drug resistance has significantly increased. Client education must be reinforced so that complete regimens of medications are taken. In which situation would one expect to find an issue with drug resistance?

residents in a long-term care facility

A client who has been on long-term geocillin therapy for repeated urinary tract infections (UTIs), reports severe abdominal cramping. The client also states that he has been having bloody diarrhea and rectal bleeding. What should the nurse suspect?

superinfection

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the healthcare provider before administering the ordered medication?

takes high-dose furosemide daily

When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions?

the need to take the medication on an empty stomach

A client is receiving Ancef 500 mg IV every 6 hours since joint surgery 3 days ago. The client reports that his arm hurts at the intravenous (IV) site. Upon examination, the nurse finds that it is red, hot to the touch and swollen. The nurse also notices a knot under the catheter insertion site. This client is exhibiting signs of which complication?

thrombophlebitis

A 4-year-old client being discharged from the hospital is ordered an oral-suspension cephalosporin. When the nurse instructs the mother to store the bottle in the refrigerator, the mother asks, "Why does that matter?" The nurse's best response would be which?

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