Module 5: Drugs for Bacterial, Tubercular, Fungal, Protozoan, Helminthic Infections

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

"Rifampin can turn body fluids orange."

A patient is being treated with amphotericin B. Which of the following statements indicates that the patient has understood the patient teaching?

"The medication may cause kidney damage."

A nurse is providing teaching to a client who has tuberculosis (TB) and a prescription for isoniazid. Which of the following instructions should the nurse include?

"You should take this medication on an empty stomach."

Rifampin (Rifadin)

-Broad-spectrum antibiotic - Bacteriostatic and bactericidal Adverse effects: Liver toxicity Urine, saliva, sweat, and tears may turn red-orange GI symptoms: Nausea Diarrhea Vomiting

A nurse is planning care for a client who is receiving gentamicin IM and has a new prescription to obtain gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample to evaluate the gentamicin peak?

1 hour after administering the IM injection

TB therapy

6-12 months Uses multidrug therapy

Pharmacotherapy of TB?

6-12 months two or more antibiotics typically administered concurrently (slow growth of bacterium) Initial phase: 2 months daily therapy RIPE (Rifampin - urine orange-red) Continue 4 months 2-3 times per week Isoniazid & rifampin

A nurse is teaching a client who has a prescription for a transdermal estradiol patch. Which of the following locations should the nurse instruct the client to apply the patch

Abdomen

Factors involved when deciding on the correct antibiotic?

Age Allergies Pregnancy Genetics Past medical history

A nurse is teaching a group of nurses about the manifestations of progestin deficency for clients who take a combination oral contraceptive. Which of the following findings should the nurse include in the teaching as an.indication of progestin deficency?

Ammenhorhea

What is chemoprophylaxis?

Antituberculosis drugs used to prevent disease in high risk populations. - Close contacts and family infected to tuberculosis patients - patients with AIDS (high risk) - Patients who are HIV positive or are receiving immunosuppressant drugs

A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for isoniazid. Which of the following laboratory values should be monitored while the client is taking isoniazid?

Aspartate aminotransferase (AST) Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine, or other findings indicating hepatitis

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client has a prescription for depo provera. At which of the following times should the client schedule to receive the first dose of the medication?

At 6 weeks postpartum

A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider?

Decreased hemoglobin

TB signs/symptoms

Fever Night sweats Loss of appetite Weight loss Cough Tiredness

A nurse is caring for a client who has been taking clomiphene to treat infertility. Which of the following findings indicate to the nurse that the medication has been effective?

Follicular enlargement and conversion to corpus luteum after ovulation

A nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. Which of the following findings should the nurse identify as a contrainidcation to the client receiving this medication?

Hep B virus

A nurse is caring for a client with multiple sclerosis and neurogenic bladder who is receiving bethanechol. The nurse should identify that which of the following client statements indicates a therapeutic action of the medication?

I am able to urinate more freely

A nurse is caring for a client who has TB and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of the medication?

I have noticed my urine is orange in color.

A nurse is providing teaching to a client who is scheduled to start taking finasteride. Which of the following statements by the client indicates an understanding of the teaching

I should see a decrease in my PSA levels

A nurse is preparing to administer oxytocin to a client who is 41 weeks gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?

Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min

A nurse is reviewing the medical record of a client who has a prescription for a oral contraceptive. The nurse should identify which of the following findings as a contraindication to receiving this medication?

Liver disease

A nurse is monitoring a client who is recieiving terbutaline to suppress preterm labor. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of the medication?

Maternal heart rate >120/min

A nurse is caring for a client who takes a combination oral contraceptive. Which of the following findings indicates the client is experiencing a deficency of estrogen in the OC?

Mid-cycle breakthrough bleeding or spotting

What serious adverse effect is most associated with amphotericin B?

Nephrotoxicity Renal impairment

A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?

Nephrotoxicity Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the client's creatinine every 3 to 4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the client's creatinine is 3.5 mg/dL or greater.

A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. The nurse should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?

Neutrophil count

Mycobacterium TB Drugs

Rifampin Isoniazide Pyrazinamide Ethambutol (RIPE)

A nurse is teaching a client who is experiencing age-related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching

This medication has fewer systemic effects than oral estrogen

A nurse is providing discharge teaching to a client who has pulmonary tuberculosis and a new prescription for rifampin. Which of the following information should the nurse provide?

Urine and other secretions might turn orange.

A nurse is teaching a client who has a prescription for a combination oral contraceptive that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching

You can miss up to 7 pills with little risk of getting pregnant as long as you have taken the pills regularly for the previous 3 weeks

The nurse is caring for a client diagnosed with a life-threatening systemic fungal infection that is not responding to treatment with an azole. What medication should the nurse anticipate the provider may order next?

amphotericin B

Fungal infections

plants like organisms that live in deep, dark places. eat dead tissue, but can enter humans through breaks in skin Treatment: Polyene antibiotics: Systemic and local infections Azoles: systemic infections

A nurse is collecting data from a client who has a C-diff infection and is receiving vancomycin via intermittent IV bolus over 60 minutes. The nurse should document the absence of which of the following conditions as a positive response to this slowed administration rate?

red man syndrome

What is Multidrug therapy?

use of multiple antibiotics increases risk of resistance Used in: -When multi-organisms cause infection -Treatment of TB -Treatment of HIV