Chapter 19

You are preparing to discharge a patient who is taking ciprofloxacin. What guidance would you offer this patient to prevent crystalluria?

"Drink at least 2 liters of fluids per day."

A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?

"I will only drink enough water to swallow the drug."

The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse?

"You may be experiencing an additional infection. I will discuss this with your health care provider."

A nurse has been performing vigilant assessments of a patient who is receiving doses of intravenous gentamicin, each over 30 minutes. A blood sample for peak gentamicin levels should be drawn

30 minutes after the drug has finished infusing.

A client with a severe infection has an order for IV gentamicin and IV penicillin. How will the nurse administer these medications?

Administer the gentamicin IV and wait 1 hour and administer the penicillin.

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

Antacids

The health care provider has prescribed moxifloxacin (Avelox) for an upper respiratory infection. The nurse identifies the client also takes amiodarone. The nurse understands that the client is at risk for;

Cardiac arrhythmia

The nurse instructs the client who is taking oral ciprofloxacin to avoid which food while taking this medication?

Cheese

Which of the following drugs is likely to be administered as a first-line treatment for anthrax exposure?

Ciprofloxacin

Which of the following are examples of fluoroquinolones? Select all that apply.

Ciprofloxacin (Cipro) Levofloxacin (Levaquin)

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.

Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order?

Culture and sensitivity

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

A 23-year-old man who works in construction calls the clinic to report that he has a rash all over his body, his skin is red, and it feels like it is burning. The nurse suspects that he is having a photosensitivity reaction from Lomefloxacin (Maxaquin), which was prescribed the day before. The nurse will instruct the client to:

Discontinue the drug immediately and return to the clinic

A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions? (Select all that apply.)

Dizziness Nausea Headache

A client is prescribed ciprofloxacin for an acute sinus infection. The nurse knows that this anti-infective medication belongs to which drug category?

Fluoroquinolones

The nursing student correctly identifies the class of drugs that exerts their bactericidal effect by interfering with the synthesis of bacterial DNA, thus preventing cell reproduction and leading to death of the bacteria, as which of the following groups?

Fluoroquinolones

Which of the following classes of antibiotics is a direct inhibitor of DNA synthesis in bacteria?

Fluoroquinolones

A 60-year-old male client with a diagnosis of bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in the client's condition and the effect of the drug treatment on his blood cultures. During morning care, the client has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this client?

Hold the next scheduled dose of gentamicin until the health care provider has been consulted.

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 male client is NPO as a consequence of a cerebrovascular accident sustained 3 years ago. His care is managed at home by his wife, and he receives all medications via gastrostomy tube. The health care provider orders a fluoroquinolone for the client to treat an infection. The nurse would instruct the client's wife to administer the medication in what way?

On an empty stomach

The client has been prescribed a drug that must be taken on an empty stomach. The nurse knows that to administer a medication on an empty stomach, it is given in which way?

One hour prior to a meal or two hours after the meal

Gentamicin therapy is indicated in the treatment of what medical diagnosis?

Osteomyelitis

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 child weighing 30 kg. The healthcare provider orders gentamicin 100 mg IV three times per day. The recommended dosage range is 6 to 7.5 mg/kg/day. What action should the nurse take?

Question the prescriber about the dosage of the medication.

The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize?

Renal function

Fluoroquinolones are primarily used to treat which of the following infections? Select all that apply.

Skin infections Bone and joint infections Sexually transmitted infections Upper respiratory tract infections

A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?

The peak and trough blood levels

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

The use of ciprofloxacin is contraindicated in pregnancy.

The nurse is caring for a client who is receiving amikacin for the treatment of a serious Staphylococcus aureus infection. What assessment should the nurse prioritize?

Urine output and creatinine clearance

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

The nurse is providing client teaching before discharging a client home. The client is taking ciprofloxacin. What action should the nurse encourage the client to prioritize?

Drink at least 2L of fluid per day.

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

Gentamicin

Fluoroquinolones are effective at treating which of the following types of infections? Select all that apply.

Gram-positive infections Gram-negative infections

A male client is concerned that he cannot afford to have his wife's community-acquired pneumonia (CAP) treated in the hospital. He has limited health insurance, and the cost of intravenous antibiotic therapy is prohibitive. According to the American College of Chest Physicians' position statement, where will the client's wife be treated?

In the home using oral drugs

When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route?

Oral

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?

Oral (PO)

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?

Ototoxicity and nephrotoxicity

A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order?

Peak and trough serum levels