Pharm exam 4 Antibiotics

A patient is administered telithromycin (Ketek) to treat a community-acquired pneumonia. What blood levels should be monitored closely with this medication?

AST and ALT Explanation: The AST and ALT are the liver enzymes and must be monitored closely with telithromycin. The creatinine level is always important to monitor but not as critical as the liver enzymes. The CPK and differential are not the primary laboratory considerations with this medication. (less)

A 25-year-old female patient who presents at the clinic with vaginal discharge and discomfort is diagnosed with chlamydia. The nurse knows that the drug of choice to treat this infection is doxycycline. What would be a priority assessment for this patient before beginning the medication?

Asking the patient if she is pregnant Explanation: Tetracyclines, such as doxycycline, are contraindicated in pregnant women and in children under 8 years of age. In the fetus and young children, the drug can inhibit bone growth and the development of enamel in the teeth. (less)

Drugs that slow or retard the multiplication of bacteria are known as which of the following?

Bacteriostatic

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component of bacterial development do these drugs affect?

Cell wall synthesis Explanation: Beta-lactam antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes. This binding produces a defective cell wall that allows intracellular contents to leak out. (less)

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 Explanation: Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular-blocking drugs and increased profound respiratory depression are the result of interaction between neuromuscular-blocking drugs and tetracyclines. Increased risk of bleeding is a result of interaction between anticoagulants and tetracyclines. (less)

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. Explanation: The older adult may be hesitent to increase fluid intake because of fear of incontinence. Fear of diarrhea, fear of skin problems and fear of allergic reaction are not related to the instruction to increase fluid. (less)

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

Gentamicin Correct Explanation: Gentamicin is classified as an aminoglycoside. Levofloxacin is a fluoroquinolone; clarithromycin is a macrolide; and cefaclor is a cephalosporin.

Which of the following represents the mechanism of action of fluoroquinolones?

Interference with the synthesis of bacterial DNA. Explanation: Fluoroquinolones exert their bactericidal effect by interfering with the synthesis of bacterial DNA; thereby preventing cell reproduction, leading to death of the bacteria.

An HIV-positive patient is in a continuing phase of TB. The patient has completed the initial phase of the treatment program. In the continuing phase, the patient has shown no positive sputum results for six months. The nurse knows that under what circumstances does the treatment in the second phase last for four months or more?

Positive sputum culture after the completion of initial treatment Explanation: Positive sputum culture after the completion of initial treatment leads to treatment in the second phase lasting for four to seven months. Following the same eating habits (diet) will not cause treatment in the second phase to last for four months or more, nor will nausea or vomiting occurring after completing the initial treatment. Treatment in the second phase does not last for four months or more in case the same food habits are followed in the continuing phase or nausea and vomiting occur after the initial phase. Noninclusion of pyrazinamide in the initial treatment leads to the second phase lasting for four to seven months or more. (less)

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. Explanation: The nurse should be careful to rotate injection sites when administering frequent parenteral injections. At the time of each injection, the nurse inspects previous injection sites for signs of swelling, redness, and tenderness. The nurse should monitor any signs of liver dysfunction monthly in patients who are being administered antitubercular drugs. The nurse should ensure that pyridoxine, and not streptomycin, is administered to the patient to promote nutrition, but this is only administered if the patient has been living in impoverished conditions and is malnourished. The nurse should monitor patient's vital signs every four hours and not once every morning

Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?

Tuberculosis is an infectious disease that usually affects the lungs but may involve most parts of the body, including lymph nodes, meninges, bones, joints, kidneys, and the gastrointestinal tract.

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

You selected: Serum BUN and creatinine levels Correct Explanation: The nurse would need to assess renal function indicated by serum BUN and creatinine levels because combining cephalosporins with aminoglycosides increases the client's risk for renal toxicity. Coagulation studies would be important if the client was receiving a cephalosporin with an oral anticoagulant because there is an increased risk for bleeding. Combining cephalosporins with alcohol could result in a disulfiram-like reaction. Assessing the client's complete blood count would not be directly indicated by the combination of cephalosporins and aminoglycosides.