Antibiotics

A nurse is teaching a patient who is preparing to travel for a month-long missionary trip to Africa. The provider has ordered chloroquine [Aralen Phosphate] as suppressive therapy. Which statement by the patient indicates a need for further teaching?

"I should continue taking the drug for 2 weeks after returning home."

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient?

"The bacteria have synthesized penicillinase."

A nurse plans to administer gentamicin (Garamycin) 50 mg intermittent IV bolus in 50 mL of 0.9% sodium chloride at 0900. The infusion will take 30 min. When should the peak level be drawn?

1000

A patient is taking oral ketoconazole [Nizoral] for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole [Prilosec] for reflux disease. What action should the nurse take?

Administer the omeprazole at least *2 hours after* the ketoconazole

Which of the following drugs inhibits bacterial beta-lactamase?

Augmentin Timentin Unasyn

The less time an antibiotic is used in the population and the more it is prescribed, the larger the percentage of resistant strains will be.

False

virulence

ability of a microbe to produce disease when present in small numbers. Ex (small pox, norovirus)

Pathogenicity

ability of organism to cause infection

A nurse is teaching an adult client with a severe infection about her prescription for ciprofloxacin (Cipro). For which of the following adverse reactions should the nurse tell the client to watch?

achilles tendon pain, yeast infection

A nurse should understand that prophylactic use of antibiotics is indicated for which of the following clients?

an older adult undergoing hip surgery

Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug?

diarrhea

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin?

first generation cephalosporin

Thin walls

gram-negative - escherichia kiebsiella, pseudomonas, salmonella

A nurse is caring for a client just admitted with an infected wound on her arm. Which of the following admission prescriptions should the nurse implement first?

obtain a wound culture

A patient is taking gentamicin (Garamycin) for a serious urinary infection. Which of the following is a serious adverse effect for this drug?

ototoxicity

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with:

red man syndrome

Bateriostatic

slow the growth of bacteria

Aerobic

with O2

Anaerobic

without O2

Which statement by a 25-year-old female client indicates that she understands the teaching that is done concerning her prescription for *tetracycline* (Achromycin)?

"I should used reliable birth control and *avoid pregnancy* while taking this drug."

The client is prescribed amoxicillin (Amoxil) for 10 days to treat strep throat. After 5 days the client tells the nurse he plans to stop the medication because he feels better. What is the best response by the nurse?

"If you stop the medication early, this could result in damage to your heart or kidneys."

A client has been diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) infection. While his medicine is being administered, he asks questions regarding his treatment on vancomycin. The nurse's appropriate response would be:

"It is necessary to continue IV therapy infusion for at least two hours for each dose and watch for nephrotoxicity."

A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct?

"Sulfonamides are bacteriostatic and depend on host immunity to work."

A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn?

30 minutes after infusion complete

A patient is being treated for septicemia. Which of the following would be the drug of choice?

Cefotaxime (Claforan)

Tetracyclines are considered first-line drugs for which disorder(s)? (Select all that apply.)

Chlamydia trachomatis cervicitis ,Lyme disease, Typhus fever (3)

A female client who is of child bearing age who is receiving penicillin to treat a streptococci throat infection.. Which of the following questions is most important to ask her before starting antibiotic therapy?

Do you take birth control pills?

A client has been prescribed ciprofloxacin (Cipro). Important information the nurse must know includes

Don't give with multivitamin.

A nursing intervention for administering sulfamethoxazole-trimethoprim (Bactrim) to a client is to:

Have the client drink a full glass of water with the medicine.

A client is receiving penicillin G Sodium/Potassium. The nurse knows that the action of the drug is by which process?

Inhibition of bacterial cell-wall synthesis

Name the generations of Cephalosporins.

Keflex: Cephalexin Sodium (1st generation) Ceftin: Cefuroxime (2nd) Claforan: Cefotaxime (3rd) Maxipime: Cefepime (4th)

A patient is prescribed penicillin for gonorrhea. He asks you if there are any side effects associated with this medication. Which of the following is a common side effect?

Penicillin G has few side effects. Although not serious, *diarrhea, nausea, and vomiting* are the most common adverse effects.

A nurse is preparing to administer a broad-spectrum antibiotic medication to a client. An important nursing intervention prior to administration regarding anti-infectives is:

Performing the culture for evidence prior to administering the first dose of the anti-infective

A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient?

The patient should check the blood glucose level more often while taking TMP/SMZ.

What is the purpose of a culture and senstivity test?

To determine which antibiotic is most effective against the infecting microorganism.

A middle age client comes into the emergency room with a fever of 104 degrees F. Systemic infection is suspected. Prior to beginning antibiotic therapy, which of the following diagnostic tests is priority for this client?

blood cultures

Which of the following terms describes a drug that is effective against a large number of different species of bacteria?

broad spectrum

Which cephalosporin may be used to treat meningitis?

cefotaxime

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (*MRSA*). What is an appropriate treatment for this patient?

ceftaroline

Thick walls

gram-positive-staph, strep, enterococci

The nurse is administering an anti-infective that is considered to be a bacteriocidal. Before beginning therapy, the nurse should assess the client for:

hypersensitivity

Bacteriocidal

kill bacteria

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir [Tamiflu]. The nurse will tell the patient that oseltamivir

may not be effective because of the delay in starting treatment.

A client comes to the clinic stating that she has been taking trimethoprim-sulfamethoxazole (Bactrim) for a bladder infection. Which of the following are side effects of this medication for which the nurse should instruct the client to watch?

photosensitivity

A nurse plans to administer gentamicin (Garamycin) 50 mg intermittent IV bolus in 50 mL of 0.9% sodium chloride at 0900. The infusion will take 30 min. For which of the following side-effects should the nurse monitor?

proteinuria, elevated bun

A client comes to the clinic stating that she has been taking trimethoprim-sulfamethoxazole (Bactrim) for a bladder infection. Which of the following are side effects of this medication for which the nurse should instruct the client to watch?

rash

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of:

renal disease

client has been on an antibiotic for 2 weeks and has developed a *superinfection*. The client asks the nurse what a superinfection is. Which of the following is the best response by the nurse?

secondary infection

While obtaining a history, the patient reports taking griseofulvin (Fulvicin) for 6 weeks. Th nurse understands that this patient is being treated for what type of infection?

superficial fungal

Which antibiotic is known as the "last chance" drug, for treatment of resistant infections?

vancomycin

The nurse is teaching a patient about taking INH. Which of the following are signs of side effects that the nurse should make the patient aware of? Select all that apply.

yellowing of the skin (jaundice) fatigue elevated hepatic enzymes loss of appetite Other effects: numbness of the hands and feet, rash, fever.