Ch. 17 (DT w/ Aminoglycosides & Fluoroquinolones)
A patient is scheduled for a bowel resection. He is to receive neomycin sulfate (Neo-Fradin) by mouth. The patient asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the patient?
"The administration will decrease the risk of contamination."
A patient is receiving gentamicin (Garamycin) to treat meningitis. The physician has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn?
08:00
A medical nurse is aware of the need to assess for potential ototoxicity in patients who are being treated with gentamicin. Which of the following patients is likely most susceptible to developing ototoxicity secondary to gentamicin?
A man who has required repeated courses of gentamicin over the past several months
Extreme caution would be necessary with the use of gentamicin in which of the following patients?
A patient who has chronic renal failure secondary to diabetes mellitus
A patient is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism?
Aminoglycoside
A patient has been prescribed ciprofloxacin after being diagnosed with a sinus infection. Which of the following should the patient avoid taking concurrently with ciprofloxacin?
Antacids
A hospital patient has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the patient's first scheduled dose, the patient develops a pronounced rash to her chest and arms. How should the nurse respond to this event?
Discontinue the infusion and inform the care provider promptly
An adult male patient with a diagnosis of osteomyelitis will soon begin treatment with gentamicin. Which of the following schedules is most likely to maximize efficacy and minimize nephrotoxicity?
Gentamicin 500 mg IV OD at 1200
The nurse is preparing to administer gentamicin (Garamycin) to a patient when he mentions that he has recently been experiencing diminished hearing. What action should the nurse take based on this statement?
Hold the dosage and notify the physician of the alteration in hearing.
A patient has been administered an aminoglycoside. It is time for his next dose, and the nurse learns his creatinine level is elevated at 3.9 mg/dL. What action should the nurse take regarding this assessment?
Hold the medication and assess the urine output.
A patient is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside?
It blocks protein synthesis of the cell wall.
A patient has been prescribed a once-daily aminoglycoside. What is the advantage of this method of administration?
It reduces the risk of nephrotoxicity.
A patient is diagnosed with multidrug-resistant tuberculosis. Which of the following aminoglycoside medications is used in a 4- to 6-drug regimen?
Streptomycin (Sulfate)
A patient with sepsis is being treated with gentamicin, and her medication regimen takes into account the phenomenon of postantibiotic effects. What are postantibiotic effects?
The ability of an antibiotic to kill bacteria even when serum concentrations are low
A patient has a genitourinary infection and is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside?
The fluoroquinolone can be given orally.
A patient is prescribed ciprofloxacin (Cipro). Which of the following nursing interventions will best prevent crystalluria?
The nurse should administer 2000 mL of oral fluids per day.
An older adult patient is recovering in hospital from an ischemic stroke and has a feeding tube in place due to dysphagia. The patient has developed an infected pressure ulcer, and ciprofloxacin suspension has been ordered as empiric therapy. How should the nurse follow up this order?
The nurse should liaise with the care provider to provide an alternative route of administration.
A nurse has informed the laboratory technician that a patient's gentamicin has finished infusing and the technician will soon draw a blood sample to determine the patient's serum drug concentration. Why is assessment of gentamicin levels necessary?
To identify whether the drug is at a therapeutic level