nurb 318 prepu ch 9
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
A client is to receive gentamicin for treatment of an infection. Which of the following would be most important for the nurse to assess to establish a baseline?
Auditory function
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?
Avoid the consumption of alcohol.
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 nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media and prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse?
"If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."
A client has been prescribed tetracycline for the treatment of acne. How would the nurse explain the action of the drug?
"Tetracycline interferes with the growth of the bacteria causing the pimples."
A client asks the nurse why fluid intake should be increased while taking sulfonamides. Which response by the nurse would be most appropriate?
"The fluids will help to decrease your risk for kidney stones."
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."
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 diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?
Aminoglycoside
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 client taking Bactrim DS one tablet twice daily for 14 days should be counseled about which of the following adverse reactions? Select all that apply.
Anorexia Crystalluria Photosensitivity
After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?
Cefuroxime
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
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
A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse should first ensure that the client has not recently eaten what type of foods?
Dairy products
A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?
Decreased absorption of tetracycline
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child?
Discoloration of the teeth
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event?
Discontinue the infusion and inform the health care provider promptly.
The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe?
Erythromycin
The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?
Fear of incontinence.
What potential adverse reaction is most likely to develop during cefazolin therapy?
Gastrointestinal upset
After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class?
Gentamicin
A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem?
Has your child been swimming a lot lately?
Penicillins and cephalosporins are used cautiously in neonates due to what factor?
Immature kidney function
A client has returned to the clinic for follow-up of an infection which is being treated with an aminoglycoside and reports ringing in the ears and dizziness. When developing this client's plan of care, which nursing diagnosis would be the priority?
Injury Risk
A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform?
Inspect mouth and gums regularly.
What is a contraindication to use of a fluoroquinolone?
Lactation
Which of the following are examples of fluoroquinolones? Select all that apply.
Levofloxacin (Levaquin) Ciprofloxacin (Cipro)
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.
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
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9°F. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?
Obtain urine for culture and sensitivity.
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 has been prescribed lomefloxacin (Maxaquin) for a respiratory infection. What must the nurse closely monitor for in this client?
Photosensitivity
The nurse is preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect?
Prolonged clotting times
A nurse is about to administer mafenide to a client. The nurse would be alert for which possible reaction?
Rash, itching, or other allergic reactions
The nurse is teaching a client about his prescription for a macrolide antibiotic. What should the nurse teach the client to report?
Recurring symptoms of infection
The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?
Renal
A client in the critical care unit is receiving aminoglycosides for an infectious process. What does the nurse need to monitor?
Renal function tests
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?
Serum BUN and creatinine levels
Common, potentially serious, adverse effects of antibiotic drugs include:
Skin rash
A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence?
Superinfection following the eradication of normal oral flora
A client asks the nurse why fluid intake should be increased while taking sulfonamides. Which response by the nurse would be most appropriate?
The fluids will help to decrease your risk for kidney stones."
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.
The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?
They disrupt the normal flora of the body.
A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy?
baseline liver function test values
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 group of nursing students are reviewing information about the different cephalosporins. The students demonstrate understanding of the information when they identify which medication should be administered with food to increase the absorption?
cefuroxime
A patient has been admitted to the intensive care unit with signs and symptoms of sepsis and preliminary results of the patient's initial blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). This finding is an indication for treatment with
daptomycin.
When fluoroquinolones are administered intravenously, the nurse would check the needle site and area around the needle site for extravasation at which frequency?
every hour
When a person is diagnosed with tuberculosis, the nurse prepares the family members to be treated prophylactically with which drug?
isoniazid
A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?
optic neuritis
The nurse is preparing to administer clindamycin intravenously (IV) to a client. How should the nurse set the infusion to run?
over 10 to 20 minutes
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
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
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
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
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
