PNE 104 Ch 7 pharmacology (PREP U)

The concentration of any drug in the body is referred to as which of the following?

Blood level

A client being treated with an oral penicillin should be encouraged to administer the medication on which schedule to best achieve a therapeutic effect?

1. around the clock 2. at regular intervals

Cultures reveal methicillin-susceptible Staphylococcus aureus in a client's postoperative wound. What medication should the nurse anticipate being prescribed for this client?

1. dicloxacillin 2. oxacillin 3. nafcillin

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

A cross-sensitivity reaction.

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.

An older adult is to receive a low dose of a cephalosporin for an infection. When realizing that this client has age-related diminished renal function, what intervention should the nurse implement?

Monitor blood creatinine levels.

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

Cephalosporins are structurally and chemically related to which classes of antibiotics?

Penicillins

A 36-year-old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

A 34-year-old female client is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The client reports gastrointestinal distress. The nurse will encourage the client to do which?

Take the drug with food.

An older adult client responded well to inclient treatment with a third-generation cephalosporin. After being largely symptom free for 48 hours, the client has developed a fever of 38.6°C and an elevated white cell count. What phenomenon may account for this client's current clinical presentation?

The client may be infected with microorganisms that were resistant to the cephalosporin.

Which is the drug of choice for surgical prophylaxis associated with a vaginal hysterectomy?

cefazolin sodium

What potential adverse reaction is most likely to develop during cefazolin therapy?

gastrointestinal upset

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections?

pseudomembranous colitis

The nurse is aware that drug resistance has significantly increased. Client education must be reinforced so that complete regimens of medications are taken. In which situation would one expect to find an issue with drug resistance?

residents in a long-term care facility

Natural penicillins have been available since 1941 to treat infections. What problem has developed since 1941?

Drug-resistant strains of microorganisms have developed.

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the client reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity

An instructor is describing an antibiotic that is resistant to the enzyme penicillinase. What would the nurse identify as an example?

Oxacillin

How will a client's diagnosis of liver cirrhosis affect the potential use of appropriate ampicillin therapy to treat an infected pressure ulcer?

The client can safely be treated with ampicillin.

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.

The nursing instructor is teaching about a new emerging bacteria that has both natural and acquired resistance and that affects the severely ill, immunocomprimised clients in intensive care, transplant, and some cancer treatment units. This is which?

VRE

A client has just received a first dose of intravenous nafcillin when he immediately begins to have difficulty breathing and loses consciousness. The nurse takes the client's vital signs: blood pressure is 88/50 with a pulse oxygenation of 88%.What should the nurse suspect?

anaphylactic reaction

A client, being prepared for surgery, has been prescribed prophylactic antibiotics. What medications would the nurse anticipate being ordered?

cefazolin

Penicillins are most effective when used to treat what type of microorganisms?

gram-positive bacteria

What preexisting condition would cause the nurse to question a prescription for the administration of intramuscular (IM) imipenem-cilastatin?

history of atrioventricular block

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

The nurse has encouraged a client prescribed oral amoxicillin to take this medication with fluids but the exception of what beverage?

orange juice

A client diagnosed with streptococcal pharyngitis should be educated concerning which drug?

penicillin G & penicillin V

When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions?

the need to take the medication on an empty stomach

The client calls the clinic to report the he is experiencing a throbbing headache and his face is flushed. The client received cefotetan as an IV antibiotic prior to a minor surgical procedure the day before, and returned home that same day. What has this client consumed that has caused this reaction?

Alcohol

The nurse is giving instructions to a client who is being discharged home with a prescription for augmentin. The nurse informs the client that the best time to take this medication is:

1 hour before meals and 2 hours after a meal.

A client with a complex medical history is scheduled to begin treatment with an IV cephalosporin. After the initiation of therapy, the nurse should monitor the client for which potential adverse effects of intravenous cephalosporin therapy?

1. nausea and vomiting 2. diarrhea 3. abdominal pain

When learning about the different classes of cephalosporins, the nurse correctly identifies which of the following statements?

A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

A 4-year-old client being discharged from the hospital is ordered an oral-suspension cephalosporin. When the nurse instructs the mother to store the bottle in the refrigerator, the mother asks, "Why does that matter?" The nurse's best response would be which?

"Drugs that require refrigeration lose potency if kept at room temperature."

To maximize the prevention of an incisional infection, when will the nurse administer the prophylactic antibiotic therapy prescribed for a surgical client?

1 hour prior to the first planned skin incision

Penicillins may trigger an anaphylactic reaction in some clients. Within what period following injection of a penicillin is anaphylaxis most likely to occur?

30 minutes

A client has been prescribed 200 mg of cefpodoxime every 12 hours. On hand are 25-milligram tablets. To meet the prescribed dose, the nurse administers ___________ tablets at each dosage.

8

Penicillin would NOT be indicated for which of the following clients?

A client with gram-negative bacteria allergic to penicillin

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

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?

Clients taking penicillin should take oral doses with a full glass of water to ensure sufficient hydration while taking the medication. The drugs should otherwise be taken on an empty stomach

A client, being treated for cellulitis with a cephalosporin, asks what the essential difference is between generations of this medication. The nurse should respond to the client's question based on what fact?

Each successive generation is more effective against gram-negative microorganisms.

A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?

The client has a new onset of jaundice and edema

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. Explanation: Clients taking oral contraceptives should be encouraged to use a barrier type of birth control during penicillin therapy; the penicillin will cause a decreased effectiveness of the contraceptive agent. The client should not be told to stop taking the oral contraceptive. This will not cause a heavier cycle. The interaction between oral contraceptives and ampicillin will not cause an increased chance of bleeding, as that interaction is between large doses of penicillin and anticoagulants.

After teaching a group of nursing students about the action of penicillin, the instructor determines that the teaching was effective when the students identify natural penicillin as exerting which type of effect on microorganisms?

bactericidal

A nurse is conducting an in-service education program for a group of nurses. When describing the action of the various classes of penicillins, which class would the nurse identify as having the narrowest spectrum of activity?

natural penicillins

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.

The nurse has administered the first dose of a client's newly-prescribed antibiotic. What assessment finding should the nurse interpret as adverse effect that suggests a more serious concern?

rash to the face and trunk

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the healthcare provider before administering the ordered medication?

takes high-dose furosemide daily

A client has been diagnosed with an infected postoperative wound, and cultures reveal methicillin-resistant Staphylococcus aureus (MRSA). The client is currently receiving intravenous cefarolin because in vitro testing indicates susceptibility. When considering the effectiveness of this client's treatment, what is the nurse's best action?

Administer the medication as ordered and monitor for expected outcomes.

A client, receiving the first dose of IV ampicillin, asks the nurse to evaluate a rash on his or her torso. What should be the nurse's initial response to the client's rash?

attempt to differentiate a hypersensitivity reaction from a nonallergic ampicillin rash