Ch 18 Macrolides and

What patient needs more teaching from the nurse?

The patient who takes erythromycin with grapefruit juice in the morning

Which patient should not receive erythromycin as ordered at 8 a.m.?

The patient with elevated liver enzymes

Lincosamides are similar to macrolides, but they are more toxic.

True

Your client developed a pressure area on her hip which has become infected. If the wound culture reveals methicillin-resistant Staphylococcus aureus, which of the following medications will you expect to be ordered?

Vancomycin

Your patient is receiving a ketolide to treat an infection. Which of the following interventions would be appropriate to include in your plan of care? Select all that apply.

• Assist patients to prevent or minimize infections. • Monitor for fever and other signs and symptoms of infection. • Monitor laboratory reports for indications of the patient's response to drug therapy.

A client has been prescribed daptomycin for treatment of an infection. What instruction is most important for the nurse to tell this client?

"Tell the physician immediately if you develop any muscle pain."

The nurse is preparing to discharge a client who has been prescribed telithromycin. The client understands the unique adverse effect associated with this drug when the client makes which statement?

"This drug may cause visual disturbances so I won't drive until I am finished with the medication."

A patient is prescribed telithromycin. The patient's laboratory test results include a creatinine of 1.8 mg/dL. What will the nurse tell the patient?

"You need a decreased dose of your antibiotic."

A patient is required to be administered vancomycin for treatment of an abdominal abscess. What should the nurse ensure when monitoring the IV infusion of vancomycin in the patient when caring for him?

Administer each dose over 60 minutes.

A male client presents to the emergency department with an abdominal dehiscence. He states he had a hernia repair 18 days earlier, and the physician removed his wound staples 5 days ago. The client states that the dehiscence occurred when he lifted a box this morning for his wife. The wound is red, and there is evidence of foul-smelling drainage. The wound is cultured, and an anaerobic bacterium is identified. The nurse understands that the physician orders metronidazole because it is effective against which type of organism?

Anaerobic bacteria

A patient taking erythromycin (E-mycin) is having difficulty hearing the nurse. How should the nurse proceed?

Ask about the patient's hearing prior to medication therapy.

After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify which of the following as an example?

Cefuroxime

A newborn presents with a distended abdomen, shallow and irregular respirations, and cyanosis. The nurse recognizes this as gray syndrome as a result of administration of which antibiotic?

Chloramphenicol (Chloromycetin)

Within 48 hours of taking erythromycin for an upper respiratory infection, what assessment finding indicates the patient has started having therapeutic effects?

Decrease in fever

Rifaximin (Xifaxan) is effective to treat traveler's diarrhea from which of the following organisms?

Escherichia coli

Your client has been diagnosed with trichomoniasis. Which of the following medication do you anticipate being ordered?

Flagyl

A patient has been taking telithromycin (Ketek) for 4 days. What is the best course of action?

Have the patient continue taking the medication.

A common reaction associated with the intravenous administration of vancomycin is "red man syndrome." What is the cause of red man syndrome?

Histamine release

A patient with acne vulgaris was administered macrolides, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case?

Inspect stools for blood or mucus.

A patient has an infection that is vancomycin-resistant and methicillin-resistant. The nurse would anticipate administering which of the following?

Linezolid

A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. Which of the following would the nurse need to monitor closely?

Liver function studies

A client presents to the physician's office with a skin infection on her forearm. The infection is resistant to over-the-counter antibiotics. After receiving the culture and sensitivity results, the physician orders tigecycline. The nurse knows that this client has what illness?

MRSA

Which statement is true concerning macrolides?

Macrolides are bacteriocidal or bacteriostatic.

You are administering erythromycin to one of your patients. For what common side effects should you monitor the patient?

Nausea, vomiting, and diarrhea

John, 34 years old, is being treated with clindamycin for osteomyelitis of his tibia following an open fracture 3 months ago. The nurse is teaching John how to properly administer the medication at home and the side effects that he needs to report to the physician. Which would be the best instruction to give John?

Notify the physician if you have any blood in your stool or diarrhea.

You are caring for a patient with severe and life-threatening pseudomembranous colitis caused by C. difficile. Which of the following drugs would you expect the patient's physician to order?

Oral vancomycin

Which assessment finding in a patient receiving telithromycin (Ketek) requires immediate action?

Prolonged QT interval

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

Which of the following is an example of a macrolide antibiotic? (Choose one)

Clarithromycin (Biaxin)

A patient who recently started taking telithromycin (Ketek) reports a headache and dizziness. What is the nurse's first action?

Continue to assess the patient.

A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient?

It is taken only once a day.

A client develops antibiotic-induced colitis. The symptoms have worsened within the past 72 hours. The nurse expects the physician to order what medication, which is considered the initial drug of choice?

Metronidazole

Your patient is receiving a miscellaneous anitbacterial to treat an infection. Which of the following goals would be appropriate to include in your plan of care? Select all that apply.

• The patient will take or receive miscellaneous antimicrobials accurately, for the prescribed length of time. • The patient will be monitored regularly for therapeutic and adverse drug effects. • The patient will verbalize and practice measures to prevent recurrent infection.

Which of the following drugs are considered to be macrolides? Choose all that apply.

• clarithromycin (Biaxin) • azithromycin (Zithromax) • erythromycin