Karch's Focus on Pharmacology 8th Ed. | Chapter 9

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 pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?

"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."

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 this with your health care provider."

In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply.

A decrease in the sensitivity of gram-positive microorganisms. An increase in sensitivity of gram-negative microorganisms.

A client is to receive ciprofloxacin and calcium carbonate. What is correct in the administration of these two medications?

Administer the calcium carbonate, and then 2 hours later administer ciprofloxacin.

A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?

Aminoglycoside

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe?

Amoxicillin

A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?

An HIV-positive client

A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction?

Antacids decrease the absorption of the drug.

A client is diagnosed with VRE, and the health care provider orders chloramphenicol. The nurse should monitor the client for the development of which side effect?

Blood dyscrasias

A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?

By administering the drug in separate IV bags

A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods?

Cheese, dairy products, and bananas

Aminoglycosides are contraindicated for all of the following clients EXCEPT:

Clients with drug-resistant TB.

Prior to administration of fluoroquinolones, which laboratory test should be obtained?

Culture and sensitivity

A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?

Erythromycin Rationale: A client who is diagnosed with a genitourinary infection that is caused by trachomatis and who is allergic to penicillin should be administered erythromycin since there is no known cross-reaction. Acamprosate calcium is administered as a substance abuse deterrent, not in place of penicillin. Atazanavir is an antiviral agent that is used to treat HIV infection, not Chlamydia trachomatis. Flumazenil is a benzodiazepine antagonist and not used for Chlamydia trachomatis.

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

A female client is diagnosed with hepatitis C as well as a urinary tract infection. The organism is sensitive to tetracycline. Why is the health care provider reluctant to order tetracycline in a client with hepatic impairment?

It slows drug elimination.

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

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

Clients taking isoniazid (INH) can experience a variety of adverse reactions but should be monitored carefully for which of the following that indicate toxicity? Select all that apply.

Peripheral neuropathy Jaundice

What organ system is responsible for the excretion of cefotaxime sodium from the body?

Renal

A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?

Rotate injection sites for frequent parenteral injections.

The health care provider considers prescribing an oral tetracycline for a client suspected of having a urinary tract infection. What action needs to be completed before the medication can be prescribed?

The health care provider should order culture and susceptibility studies. Rationale: Culture and susceptibility studies are needed before tetracycline therapy is started, because many strains of organisms are either drug resistant or vary greatly in drug susceptibility. Teaching the client about proper storage and adverse effects, including photosensitivity, are appropriate after the medication is ordered. There is no cross-allergenicity with penicillin, so prescribing a tetracycline does not require assessment penicillin hypersensitivity.

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.

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

Weight and renal function

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

The nurse caring for a client diagnosed with Mycoplasma pneumonia should prepare medication information on what medication?

doxycycline

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.

drop in blood pressure increase in respiratory rate sudden increase in temperature

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication?

jaundice

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

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?

skin rash or itching

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 (Bactrim)

A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug?

warfarin