Chapter 9: Antibiotics

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 health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?

"Are you pregnant?"

A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?

"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."

A client comes to the emergency department reporting a throbbing headache, nausea, vomiting, chest pain, dyspnea, vertigo, and blurred vision. The client reveals taking cefaclor for an infection. Which question would the nurse ask next?

"Have you had any alcohol to drink in the past 72 hours?"

Which statement by a client taking a sulfonamide requires further instruction?

"I will make sure to use extra sunscreen when I go to the tanning booth."

The nurse educates a client about using the prescribed otic 0.5% hydrocortisone, 10,000 units polymyxin B, 4 drops QID in right ear x 10 days. Which client statements determine the need for further clarification?

"I will place the bottle tip into the ear and instill the 4 drops."

A client scheduled for a bowel resection is to receive neomycin sulfate by mouth. The client asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the client?

"The administration will decrease the growth of intestinal bacteria."

An older adult diagnosed with necrotizing otitis externa has been receiving IV ciprofloxacin and is now transitioning to the oral form of the drug. What health education should the nurse provide to the client?

"You can take this medication with food to reduce the chance that it will upset your stomach."

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."

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?

"Your urine or sweat may become orange in color."

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?

225 mg

A client has been prescribed 2 tablets of 150 mg isoniazid every day. The available drug is in the form of a 100-mg tablet. To meet the recommended dose, the nurse will administer__________ tablets each time.

3

It would be most important for a nurse to monitor which client for ototoxicity while on gentamicin therapy?

A 25-year-old male who has a hearing impairment

The caregiver of a 12-year-old, diagnosed with acute otitis externa, has asked if oral medications might be more effective than the prescribed ear drops. The nurse should respond in the knowledge that systemic medications for the treatment of otitis externa are only indicated in what circumstances?

A deep tissue infection develops

Which is an example of a first generation cephalosporin?

Cefadroxil

The nurse is caring for a client who is taking methotrexate for rheumatoid arthritis and will be taking a sulfonamide for a urinary tract infection. What laboratory results will be most important for the nurse to monitor?

Complete blood count

Which of the following should be included in the nurse's pre-administration assessment prior to a client receiving a cephalosporin?

Current symptoms Medication history Allergy history Medical history

A nurse is caring for a client daignosed with a serious gram-negative infection prescribed amikacin. Which action should the nurse prioritize while caring for this client?

Do renal tests daily

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

Gentamicin

A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions?

Headache Nausea Dizziness

A nurse is administering ciprofloxacin IV. What should the nurse assess prior to administering the medication?

Inspect the needle site for signs of tenderness, pain, and redness.

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.

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 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?

Monitor for appearance of adverse reactions.

The nurse knows that tuberculosis (TB) is an infectious disease seen around the world and in many cases due to overcrowding. The nurse would be aware of this condition if the lab reports showed which bacteria?

Mycobacterium tuberculosis

A client with an infected ulcer on the foot has been prescribed daptomycin. What action should the nurse ensure has been taken to determine that the drug will be effective in treating the infection?

Obtain a culture of the client's 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

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?

Penicillins

A client has been prescribed lomefloxacin (Maxaquin) for a respiratory infection. What must the nurse closely monitor for in this client?

Photosensitivity

Tuberculosis responses well to long-term treatment with a combination of three or more antitubercular drugs. Which is true regarding the duration of treatment for clients with tuberculosis?

Prophylactic treatment should be given for six to 12 months. The continuation treatment phase should last for four to seven months. The initial treatment phase should last for a minimum of two months

A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Review lab results to confirm normal liver function.

A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option?

Rifampin

Which of the following are considered primary drugs to treat tuberculosis?

Rifampin (Rifadin) Isoniazid (Nydrazid) Ethambutol (Myambutol)

A patient with TB is undergoing initial therapy in the treatment. The nurse has to administer three or more drugs in combination to the patient. The patient wishes to know the reason for administering a combination of drugs. Which of the following explanations does the nurse offer related to the combination of medications?

Slows down bacterial resistance

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?

Take the drug on an empty stomach.

A 72-year-old client has been prescribed ciprofloxacin. What instruction for home care has the highest priority?

Take this medication with extra fluid.

A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed?

Tetracycline

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

How will a client's diagnosis of liver cirrhosis affect the potential use of appropriate ampicillin therapy to treat an infected pressure ulcer?

The client can safely be treated with ampicillin

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 client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?

The need to consistently take the prescribed drugs in order to cure TB

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

Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment?

The patient will require vigilant monitoring of blood glucose levels.

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.

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 who routinely takes antacids has been prescribed a oral fluoroquinolone for an infection. The nurse instructs the client to take the antibiotic at which times?

Two to four hours before, or six to eight hours after the antacid

Aminoglycosides must be used cautiously in children as in adults. Dosage must be accurately calculated according to which factors?

Weight and renal function

A homeless client presented at a street clinic with reports of hemoptysis and subsequently tested positive for TB. Which characteristics of the client's present circumstances would preclude treatment with INH?

an alcoholic who has hepatitis C (HCV)

After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which types of medication?

bacteriostatic

A 9-year-old client has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the client's admission orders and notes that IV demeclocycline has been prescribed. After beginning this treatment, the nurse should confirm the results of what laboratory test?

blood urea nitrogen (BUN)

A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?

changing to a different antibiotic

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

An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin?

diarrhea

A nurse is assessing a client for possible adverse reactions associated with fluoroquinolone therapy. Which possible reactions would the nurse attribute to this therapy?

diarrhea nausea abdominal discomfort

A client with a complex medical history is scheduled to begin with an IV cephalosporin. After the initiation of therapy, the nurse should monitor the client for which potential adverse effect of intravenous cephalosporin therapy?

diarrhea nausea and vomiting abdominal pain

The nurse understands that tuberculosis (TB) can affect other organs of the body. The term used for TB outside the lungs called which?

extrapulmonary

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

What preexisting condition would cause the nurse to question a prescription for the administration of intramuscular (IM) imipenem-cilastatin?

history of atrioventricular block

Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason?

increasing resistance

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description?

inhibiting bacterial protein synthesis

A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice?

it is metabolized in the liver

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test?

liver function

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 client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?

on an empty stomach

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

oral (PO)

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

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

photosensitivity

A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client?

renal damage

While reviewing the medication administration record of a client, the nurse sees that sulfasalazine has been prescribed. What medical diagnosis does the nurse suspect the client might have?

rheumatoid arthritis ulcerative colitis

The nurse has administered a client's first scheduled dose of amoxicillin. What subsequent client report should prompt the nurse to seek the discontinuation of this drug?

shortness of breath

Common, potentially serious, adverse effects of antibiotic drugs include:

skin rash

In the rare instance in which penicillin is considered essential, hypersensitivity can be assessed by administering:

skin test

A nurse is caring for a 52-year-old man with pyelonephritis. The health care provider has prescribed gentamicin. Which pair of symptoms would alert the nurse to a serious adverse reaction?

tinnitus and decreased urinary output

An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed?

trimethoprim-sulfamethoxazole