PN119 PrepU Chapter 9
The nurse instructs the patient prior to discharge to complete the entire course of treatment of an anti-infective. The patient reports that he does not like to take a lot of drugs and asks why can't he stop taking the medicine if he feels better. The nurse's best response would be which of the following?
"Failure to complete the entire treatment may result in a return of the infection."
Which of the statements by the client identifies an understanding of psueodomembranous colitis?
"If I have blood or mucus in my stools, I will collect a sample."
The physician has ordered levofloxacin 500 mg orally. The drug is available in 250 mg tablets. The nurse administers how many tablets?
2
Which of the following represents the mechanism of action of fluoroquinolones? (Choose one)
Interference with the synthesis of bacterial DNA.
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 of the following ways?
One hour prior to a meal or two hours after the meal
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse focuses education on which adverse reaction?
Photosensitivity
Common, potentially serious, adverse effects of antibiotic drugs include:
Skin rash
The client has received the first dose of oral Cipro. The client reports shortness of breath. The nurse suspects:
hypersensitivity reaction.
A nursing student is learning about the new drug linezolid (Zyvox) and the many different adverse reactions associated with it. The student lists which of the following as the most serious adverse reactions caused by linezolid? (Select all that apply.)
thrombocytopenia pseudomembranous colitis
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 best response?
"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which of the following statements made by the client would indicate the need for additional education?
"I will limit my fluid intake."
Effective against streptococci, what generation of fluoroquinolones is levofloxacin (Levaquin): first (1), second (2), third (3), or fourth (4)? Fill in the blank with a number.
3
A nurse who provides care in diverse settings is aware that ciprofloxacin in among the more commonly-prescribed antibiotics. In which of the following patients would the use of oral or parenteral ciprofloxacin require caution or be contraindicated? (Select all that apply.)
A 13-year-old boy who developed cellulitis (tissue infection) several days after scraping his elbow A 71-year-old woman with a respiratory infection who takes warfarin because of her history of atrial fibrillation A 68-year-old woman with type 1 diabetes who has developed an infection in her left knee joint
For a patient diagnosed with methicillin-resistant Staphylococcus aureus (MRSA), which medication would be most effective?
An oxazolidinone
A nurse knows that when administering intravenous (IV) carbapenem, the highest priority action after administration is:
Assessing the IV site
Fluoroquinolones treat infection by which of the following effects? (Choose one)
Bactericidal
The client has been started on levofloxacin (Levaquin) for a respiratory infection. The client is now experiencing sores in his mouth. The nurse suspects this is due to what type of superinfection?
Candidiasis
A patient has been diagnosed with a community-acquired skin infection and has been prescribed linezolid (Zyvox). Which of the following foods should not be eaten during the administration of this medication?
Cheddar cheese
The physician has prescribed ciprofloxacin. For which patient would you contact the physician to clarify the order because the medication is contraindicated? (Select all that apply.)
Children younger than 18 Pregnant and lactating mothers
Which of the following medications are associated with QT interval prolongation on electrocardiogram (ECG)? Select all that apply.
Ciprofloxacin Ofloxacin Levofloxacin Moxifloxacin
A patient presents to the clinic reporting severe polyuria and dysuria. What medication would the nurse expect this patient to be prescribed?
Ciprofloxacin (Cipro) 250 mg PO BID x 3 days
What must be taken into consideration when an antibiotic is chosen?
Culture and sensitivity test results
Which of the following is the only drug in a class of antibiotics called cyclic lipopeptides?
Daptomycin (Cubicin)
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 client is receiving ciprofloxacin for a urinary tract infection. This drug is administered IV. During an infusion, the nurse notes fluid leaking into the tissue around the IV site. What is the best response of the nurse?
Discontinue the IV.
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
Daptomycin (Cubicin) can be used to treat which of the following?
Gram-positive bacteria
The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?
Inhibiting cell wall synthesis
A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor?
It is important to use antibiotics cautiously and to teach the patients to complete the full course of an antibiotic prescription.
The client is being started on oral ciprofloxacin (Cipro). The nurse identifies that the client is also taking corticosteroids. What is the most appropriate action of the nurse?
Notify the physician
A nurse knows that promoting an optimal response to drug therapy is a desired outcome when a patient is receiving a fluoroquinolone. One important action the nurse should include in the plan of care is which of the following?
Observe the patient for the first 48 hours for adverse reactions to the drug.
The nurse identifies which of the following clients as being at risk for a superinfection?
Older adults
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 is the advantage of fluoroquinolones over aminoglycosides?
Oral administration for more serious infections
A patient who has been receiving intravenous (IV) vancomycin begins to report neck and back pain as well as feeling hot and having chills. The nurse assesses the patient and notices that the neck is red. The patient's temperature is 102 degrees F; BP is 86/58. This patient is showing signs and symptoms of which of the following syndromes?
Red-man syndrome
The nurse correctly identifies the following as common uses for fluoroquinolones. (Select all that apply.)
Respiratory infections Bone and joint infections Urinary tract infections Skin infections Sexually transmitted infections
A patient has been administered anti-infectives. The nurse has to conduct an ongoing assessment on the patient as part of her care. Which of the following observations is the nurse most likely to make when performing the ongoing assessment for this patient?
Significant drop in blood pressure
The client has been prescribed levofloxacin. The nurse knows that the client should be taught to do which of the following?
Swallow the pill.
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 client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
The client has developed a superinfection.
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 patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
The use of ciprofloxacin is contraindicated in pregnancy.
The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?
They disrupt the microbial flora of the body.
What action do fluoroquinolone drugs such as levofloxacin have on bacteria?
They prevent cell reproduction.
A nursing instructor is teaching students about miscellaneous drugs that work by inhibiting cell wall synthesis. These include which of the following? (Select all that apply.)
carbapenems vancomycin monobactams
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include to:
increase fluid intake.
A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?
phlebitis
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is mixed in a syringe for an IV pump as a solution of 250 mg/15 mL. How many mL should be in the syringe?
45
A patient has received a prescription for amoxicillin (Amoxil) 500 mg PO q6h for 10 days for a sinus infection. After the fifth day, the patient is feeling much better. How should the nurse counsel this patient?
Continue taking the medication until you have taken every pill.
A client is prescribed ciprofloxacin for an acute sinus infection. This drug belongs to what category of anti-infective medications?
Fluoroquinolones
A patient is prescribed ciprofloxacin 500 mg po twice a day. The nurse notes that the ciprofloxacin is scheduled to be given with breakfast. The nurse correctly administers ciprofloxacin _____
Twice daily po, 2 hours after the meal