Pharm 9
Tetracyclines should not be used in children younger than 8 years of age because of their effects on:
Teeth and bones
What is an important precaution of fluoroquinolones that should be included in the client teaching?
Tendon Rupture
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."
After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement?
"I need to wear protective clothing when I'm out in the sun."
After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following?
"I should drink a full 8-oz glass of water when I take the medicine."
A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?
"I will only drink enough water to swallow the drug."
The clinic nurse is responsible for teaching a client about a new prescription for doxycycline. The nurse should increase which instruction in the teaching?
"Limit your exposure to the sun."
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 diagnosed with tuberculosis (TB) has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?
"The use of multiple drugs prevents the development of drug-resistant TB."
An adult client prescribed trimethoprim-sulfamethoxazole should receive what information concerning potential adverse effects?
"This drug might make your stomach a bit upset, so let me know if you experience that."
A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?
"You will have multidrug therapy for 6 to 24 months."
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day?
8
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.
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 with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?
BUN and creatinine
The ability of bacteria to produce substances that inactivate or destroy the antibiotic is known as which of the following?
Bacterial resistance
Drugs that destroy bacteria are known as which type of drug?
Bactericidal
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 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 public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI?
Chlamydia
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
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?
Confirm the client's allergy status.
Which nursing diagnoses are used with fluoroquinolones therapy? Select all that apply.
Diarrhea Acute Pain Risk for Impaired Comfort Risk for Impaired Skin Integrity
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.
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 nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?
Inflammation of the tongue and mouth
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication?
Jaundice
A male client is prescribed aminoglycosides for a bladder infection secondary to benign prostatic hypertrophy. The nurse understands that these drugs reach higher concentrations in which areas of the body? (Select all that apply.)
Kidneys Inner ears
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely?
Liver function studies
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 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient?
Monitoring 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
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?
Nephrotoxicity
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 Contraceptive
An instructor is describing an antibiotic that is resistant to the enzyme penicillinase. What would the nurse identify as an example?
Oxacillin
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 aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?
Renal
A 72-year-old female clinic patient is started on trimethoprim-sulfamethoxazole for treatment of a urinary tract infection. Prior to administering this drug, the nurse should assess the patient for which of the following conditions?
Renal Impairment
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?
Rifampin and isoniazid
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.
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?
Serum BUN and creatinine levels
The nurse is caring for a client who is taking tetracycline for Rocky Mountain spotted fever. The nurse notices that the client has developed painful mouth ulcers. The nurse knows that the client has developed what adverse reaction to the medication?
Stomatitis
A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as:
Super infection
The nurse understands that which is the highest priority when teaching about antitubercular medications?
Taking medications as prescribed
Which statement is true in regards to the oral administration of tetracyclines?
Tetracyclines should be administered with a full glass of water
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
The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
The client has developed a superinfection.
A client is prescribed rifampin. What information should the nurse include in the client's medication education?
The urine, tears, sweat, and other body fluids will be a discolored red-orange.
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 is asking how fluoroquinolones work. What is the nurse's best response?
They interfere with the DNA of the bacteria.
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.
When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?
alcohol
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?
antacid
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)
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
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
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.
When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline?
creatinine of 2.8 mg/dL (247.52 µmol/L) (high)
A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?
drug-resistant tuberculosis.
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
A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?
frequent swimming and water sports while the child was on vacation
What potential adverse reaction is most likely to develop during cefazolin therapy?
gastrointestinal upset
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
Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?
penicillins
A client has been admitted with leprosy. The nurse completes the health history and physical examination. In addition to a thorough assessment of the skin, what other areas of the body would be important to assess? (Select all that apply.)
peripheral nerves mucosa of the gastrointestinal tract
When instructing the client with tuberculosis (TB) about the drug Isoniazid, the nurse advises that the most common symptom of toxicity is:
peripheral neuropathy.
What event triggers the development of a superinfection?
proliferation of antibiotic-resistant microorganisms
A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed?
tetracycline
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
with a glass of water 1 hour before or 2 hours after a meal.
In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences:
yellowing of the eyes or skin