Pharmacology Prep U Chapter 8 Anti-Infective Agents

What would contribute to drug resistance?

Antibiotic prescription for viral illness

A client is admitted to the hospital with elevated temperature, chills, cough, and fatigue. The health care provider orders a chest x-ray, which indicates pneumonia. The blood cultures also come back positive for a Gram-negative bacillus. The provider orders two antibiotics to be given to the client, one for Gram-negative organisms and one for Gram-positive organisms. Why does the provider not prescribe just one antibiotic for both types of bacteria?

Broad-spectrum antibiotics can cause antibiotic resistance.

An adult client has been treated for strep throat with ampicillin by mouth. The client visits the occupational health nurse and states she has vaginal itching. What organism is the cause of the vaginal itching?

Candida

After teaching a group of students about adverse reactions to anti-infective agents, the instructor determines that the students need additional teaching when they identify what as a common adverse effect?

Cardiac toxicity

A client is to be started on an antibiotic. Which is most important to take into consideration before beginning the antibiotic regimen?

Culture and susceptibility

A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead?

Development of drug resistance

The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug?

It will directly cause the death of pathogenic cells.

The nurse is preparing to administer an anti-infective agent that is prescribed for an older adult. The nurse should prioritize what action?

Monitor the client closely for signs of adverse effects

Which intervention is necessary to perform prior to initiating antibiotic therapy?

Obtain a specimen for culture and sensitivity.

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?

Obtaining sensitivity testing

An older adult client has been brought to the emergency department by her daughter, who states that the client may have a urinary tract infection. What principle should guide the care team's plan of treatment?

Older adults' signs and symptoms of infection may differ from those of younger people

An 82-year-old woman with influenza and pneumonia has been admitted to the hospital for IV antibiotic therapy. Which type of antibiotic would rely the least on the client's defense mechanisms?

Penicillin

A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?

Refer the client to the health care provider because the client may be experiencing resistance.

A client has been taking vancomycin 750 mg PO q6h for the past four days to treat Clostridium difficile-related diarrhea. The nurse learns that the client's 24-hour urine output was 550 mL yesterday and that is has been 125 mL over the past 12 hours. What is the nurse's best action?

Report the findings promptly to the client's care provider.

The nurse understands that an infection caused by a secondary pathogen, which can occur during prolonged antibiotic therapy, is known as which of the following?

Superinfection

The family members of an older adult client are angered that the client has been colonized with methicillin-resistant Staphylococcus aureus during a stay in the hospital. The nurse should explain what characteristic of colonization to the members of the family?

The bacteria are present but are not causing infection.

A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?

The client has a new onset of jaundice and edema

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 30-year-old female client received an insect bite that has progressed to cellulitis over the past several days. What client characteristic should the nurse prioritize when administering anti-infectives?

The client is in the second trimester of pregnancy.

A medical nurse on a night shift is reviewing a client's medication administration record for the following day. The nurse notes that a combination antimicrobial drug is prescribed. What is implied by the fact that the client has been prescribed a combination drug?

The client may have an infection caused by multiple microorganisms.

A nurse has questioned why a client's health care provider has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?

The use of broad-spectrum antibiotics can create a risk for a superinfection.

A nurse is asked to explain the difference between community-acquired infections and nosocomial infections. What response best describes the difference?

Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired.

A client has returned for the third time to the provider's office after repeated doses of different antibiotics. Which does the nurse suspect?

antibiotic resistance

A client comes to the clinic reporting mouth sores that appear consistent with an oral yeast infection. The nurse should question the client about recent use of:

antibiotics

Administration of what type of antibiotic by the nurse would be most likely to cause a superinfection?

broad spectrum

A client is receiving aminoglycoside therapy. The nurse would be alert for:

kidney dysfunction.

What intervention is necessary for the nurse to perform prior to initiating prescribed antibiotic therapy?

obtaining a specimen for culture and sensitivity

A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to contribute to antibiotic resistance?

overuse of antibiotics

What occurs when the normal flora is destroyed by the use of anti-infectives?

superinfection

Successful treatment with bacteriostatic antibiotics depends upon:

the ability of the host's immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy.

A critically ill client has developed a fever of 38.9°C, and blood cultures have been drawn and sent to the laboratory for culture and sensitivity testing. Determination of the culture will give the care team what information?

the exact identity of the infectious microorganism

A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that:

the microorganism causing the infection is likely known.

What is a major factor that influences whether an individual will acquire an infection?

the person's ability to defend against the would-be invaders

An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with

vancomycin

Successful treatment with bacteriostatic antibiotics depends upon what factor? Select all that apply.

• The ability of the host's immune system to eliminate the inhibited bacteria. • Providing an adequate duration of appropriate drug therapy.

The nurse would be most likely to investigate the possibility of a superinfection in a client presenting with infections caused by what? (Select all that apply.)

• Yeast • Proteus • Pseudomonas

Which client would be at risk of developing an infection? Select all that apply.

• a client with an impaired immune system • a client experiencing diarrhea chronically • an elderly client who has one chronic disease

The hospital nurse is caring for a group of adult clients. For which client should the nurse most likely administer prophylactic anti-infectives?

A client with colorectal cancer who is pre-operative for a bowel resection

The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate?

A client with signs of infection who is awaiting the results of laboratory testing

A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which statement most accurately describes selective toxicity?

A drug harms microbes without harming human cells.