NURS 125: Chapter 9: Antibiotics

A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's bestresponse?

"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?

"Are you pregnant?"

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?

225 mg

A 26-year-old female client with a skin infection has been prescribed 400 mg ampicillin to be taken orally. Which instruction should the nurse include in the client teaching plan?

Ampicillin will reduce the effectiveness of birth control pills.

A client has been prescribed ciprofloxacin after being diagnosed with a sinus infection. What medication should the client avoid taking concurrently with ciprofloxacin?

Antacids

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 client is to receive gentamicin for treatment of an infection. Which of the following would be most important for the nurse to assess to establish a baseline?

Auditory function

A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?

Avoid the consumption of alcohol.

Which of the following would a nurse identify as being classified as a macrolide?

Azithromycin

A nurse suspects that a client receiving oral penicillin therapy is developing pseudomembranous colitis based on which assessment finding?

Bloody diarrhea

A nursing instructor is preparing a teaching plan for a group of nursing students about macrolide antibacterial drugs. Which factors would the instructor expect to include? Select all that apply.

Broad-spectrum antibiotics, May cause visual disturbances, Can be used in clients allergic to penicillins, Can be used to treat acne vulgaris

Tetracyclines are generally contraindicated in pregnant women because of what effects? (Select all that apply.)

Cause fatal hepatic necrosis in the mother, Interfere with bone and tooth development in the fetus.

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect?

Cell wall synthesis

An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?

Confirm the client's allergy status.

A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?

Drug-resistant tuberculosis

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

Gentamicin

Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason?

Increasing resistance

A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?

Inflammation of the tongue and mouth

A client being treated for tuberculosis is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis?

Isoniazid and rifampin

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 female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice?

It is metabolized in the liver.

A female client is diagnosed with hepatitis C as well as a urinary tract infection. The organism is sensitive to tetracycline. Why is the health care provider reluctant to order tetracycline in a client with hepatic impairment?

It slows drug elimination.

Which would be considered a penicillinase-resistant antibiotic?

Nafcillin

The nurse should monitor the client for which common side effects of erythromycin therapy?

Nausea, vomiting, and diarrhea

The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply.

Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy, Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy, Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated.

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

Oral

The nurse is observing a graduate nurse administering medications. The other nurse would intervene if the graduate nurse attempted to give what medication intravenously?

Penicillin G benzathine

A client has been prescribed lomefloxacin (Maxaquin) for a respiratory infection. What must the nurse closely monitor for in this client?

Photosensitivity

A client is prescribed demeclocycline. The nurse would teach the client to be alert for which signs or symptoms?

Photosensitivity

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 preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect?

Prolonged clotting times

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

Renal damage

A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Review lab results to confirm normal liver function.

Which drug-specific nursing conclusion(s) may be used in the administration of a cephalosporin? Select all that apply.

Risk for impaired comfort, Risk for impaired skin integrity at injection site, Impaired urinary elimination, Diarrhea

After administering sulfonamides to a client, the nurse observes the client has developed a fever, cough, and muscular aches, as well as lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which possible adverse reaction?

Stevens-Johnson syndrome (SJS)

A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence?

Superinfection following the eradication of normal oral flora

A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?

Take precautions to prevent photosensitivity.

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 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.

A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client?

These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.

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

To prevent resistance

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?

Urinary tract infections

The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client?

Use a type of barrier birth control while you are taking this antibiotic.

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

The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects?

Vomiting and diarrhea

A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy?

baseline liver function test values

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

can cause allergic reactions in clients who are allergic to penicillins.

The nurse is reviewing recent laboratory values for an older client prior to administration of tetracycline. Which finding would lead the nurse to hold the dose?

creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

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

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 night nurse administered a PRN dose of aluminum hydroxide with magnesium hydroxide to a client at 06:40. What action should the dayshift nurse take when preparing to administer the client's scheduled 08:00 dose of oral tetracycline?

hold the tetracycline until 08:40

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description?

inhibiting bacterial protein synthesis

The nurse is assessing a client who has been prescribed treatment with isoniazid. What assessment finding would most likely necessitate contacting the health care provider to recommend discontinuing treatment?

jaundice

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

methicillin-resistant Staphylococcus aureus (MRSA) infection

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.

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

oral (PO)

A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:

oral contraceptives.

A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed?

tetracycline

In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences:

yellowing of the eyes or skin.

A client comes to the emergency department reporting a throbbing headache, nausea, vomiting, chest pain, dyspnea, vertigo, and blurred vision. The client reveals taking cefaclor for an infection. Which question would the nurse ask next?

"Have you had any alcohol to drink in the past 72 hours?"

A client is receiving gentamicin to treat meningitis. The health care provider has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn?

08:00

The ability of bacteria to produce substances that inactivate or destroy the antibiotic is known as which of the following?

Bacterial resistance

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 bestresponse?

Continue to monitor vital signs.

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 allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?

Erythromycin

The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe?

Erythromycin

The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?

Has the child taken tetracycline for treatment?

A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform?

Inspect mouth and gums regularly.

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?

Jaundice

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

Levofloxacin (Levaquin), Ciprofloxacin (Cipro)

n which condition present in the client should macrolides be used with caution?

Liver dysfunction

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test?

Liver function

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 providing care to a client who is receiving an aminoglycoside and cephalosporin. Which assessment is a priority of care?

Nephrotoxicity

A nurse is preparing to administer an aminoglycoside to a client. The nurse would be alert for the development of which toxicities? Select all that apply.

Nephrotoxicity, Ototoxicity, Neurotoxicity

A nurse is about to administer mafenide to a client. The nurse would be alert for which possible reaction?

Rash, itching, or other allergic reactions

A client undergoing penicillin therapy shows improvement and confirms feeling better. Which intervention is the nurse most likely to perform in such a situation?

Record assessments on client's chart.

A nurse is required to administer a parenteral form of penicillin to a client. Which intervention would be most appropriate for the nurse to do when preparing penicillin in parenteral form?

Shake the vial well to distribute the drug evenly.

After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was successful when the students choose which medication as an example of a sulfonamide antibiotic? Select all that apply.

Sulfamethoxazole/trimethoprim, Silver sulfadiazine

Erythromycin is sometimes used as a penicillin substitute. For prevention of what condition might a nurse note a substitute of erythromycin for penicillin?

Syphilis

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?

Take the drug on an empty stomach.

The nurse understands that which is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition?

Ulcerative Colitis

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?

numbness and tingling in his feet

A group of nursing students are reviewing the uses for fluoroquinolones. The students demonstrate understanding of the information when they identify which condition as a typical use? Select all that apply.

pneumonia, urinary tract infection, sinus infection

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

The nurse is teaching a client receiving cephalosporin therapy about events to immediately report to the healthcare provider. The nurse determines that the teaching was successful when the client identifies which sign(s)/symptom(s)? Select all that apply.

severe diarrhea, abdominal pain, vomiting