Pharmacology PrepU Chapter 9: Antibiotics

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

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.

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?

To prevent resistance

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?

antacids

The nurse understands that tuberculosis (TB) can affect other organs of the body. The term used for TB outside the lungs called which?

extrapulmonary.

A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will:

monitor the patient for bleeding gums

A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client?

renal damage

A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted?

renal disease

A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective?

"I will apply it in a very thin layer over the area."

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."

A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide?

10 lb weight loss

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.

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

The client has been taking levofloxacin IV since admission 12 hours ago for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response?

Continue to monitor vital signs.

A client with TB is prescribed pyrazinamide. The nurse should assess and monitor for which of the following adverse reactions of pyrazinamide in the client?

Diarrhea

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

Gentamicin

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

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 degrees ferenheit. 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.

The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present?

Perform culture and susceptibility tests.

The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration?

Phlebitis

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction?

Photosensitivity

The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?

Red man syndrome

A 72-year-old client has been prescribed ciprofloxacin. What instruction for home care has the highest priority?

Take this medication with extra fluid.

When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?

alcohol

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

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?

penicillins

The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media 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 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."

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

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

A 67-year-old client with a history of chronic illness is receiving penicillin therapy. The client's age and health history indicate an increased susceptibility to pseudomembranous colitis. The nurse would be alert for which finding? Select all that apply.

-bloody diarrhea -rectal bleeding

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 25-year-old female client 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 client before beginning the medication?

Asking the client if she is pregnant

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 client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic?

Decreased absorption

The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug?

Diarrhea and nausea

A client treated for a respiratory infection is being treated with levofloxacin. The client reports diarrhea, abdominal cramping, and a fever. What is the action of the nurse?

Discontinue the levofloxacin.

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?

It inhibits cell wall synthesis.

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

Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment?

The patient will require vigilant monitoring of blood glucose levels.

The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?

Vaginal itching and discharge

A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client?

culture and sensitivity test

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.

What physical characteristic observed in an adult suggests that they were prescribed tetracycline as a child?

discoloration of the teeth

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

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

A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:

route

The nurse has administered a client's first scheduled dose of amoxicillin. What subsequent client report should prompt the nurse to seek the discontinuation of this drug?

shortness of breath

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