220 - Chp 21 - PrepU - Q&A

Which client should not receive erythromycin as ordered at 8 a.m.?

The client with elevated liver enzymes

A patient on your unit has bacterial colitis and is being treated with oral vancomycin. Why is vancomycin given orally, rather than intravenously, in the treatment of bacterial colitis?

The oral version of the drug acts within the bowel lumen.

The client has developed a pressure area on the hip that has become infected. If the wound culture reveals vancomycin-resistant enterococci (VRE), which medication will the nurse expect to be prescribed?

linezolid

The nurse is caring for a client who has been diagnosed with trichomoniasis. What medication would the nurse anticipate being prescribed?

metronidazole

A client developed a pressure area on the hip that has become infected. If the wound culture reveals methicillin-resistant Staphylococcus aureus, which medication would the nurse expect to be prescribed?

vancomycin

The nurse is discussing the administration of clindamycin with a group of novice nurses. The experienced nurse should include which statement(s) to help ensure client safety? Select all that apply.

- "You need to dilute 600 mg of clindamycin in at least 50 ml of IV fluid and deliver it over 10-20 minutes in order to decrease the risk of phlebitis." - "Reconstituted oral clindamycin needs to be stored at room temperature to maintain its pourability." - "Never administer clindamycin as a bolus since that can trigger cardiac arrest." - "Neonates and infants prescribed clindamycin require close monitoring of both their renal and hepatic functioning."

Which of the following characteristics best describes macrolides? Choose all that apply.

- May be bacteriostatic or bactericidal - Effective against gram-positive cocci - Erythromycin is the prototype

A health care provider is deciding what medication to prescribe for a client with an upper respiratory infection. What principles guide the provider's decision? Select all that apply.

- Resistance of the bacteria - Other drugs the client is taking daily - The client's ability to tolerate the drug

Which medication administration information should the nurse include when providing discharge instructions to a client being prescribed oral erythromycin? Select all that apply.

- Take medication 1 hour before or 2-3 hours after meals. - Take medication with 8 ounces of water.

Your patient is receiving a miscellaneous antibacterial to treat an infection. Which of the following goals would be appropriate to include in your plan of care? Select all that apply.

- The patient will be monitored regularly for therapeutic and adverse drug effects. - The patient will verbalize and practice measures to prevent recurrent infection. - The patient will take or receive miscellaneous antimicrobials accurately, for the prescribed length of time.

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.

- decrease in blood pressure - increase in respiratory rate - sudden increase in temperature

Which of the following drugs are considered to be macrolides? Choose all that apply.

- erythromycin - azithromycin (Zithromax) - clarithromycin (Biaxin)

The nurse is preparing to administer IV vancomycin to a client for the treatment of a systemic infection. How long would the nurse expect the infusion to run?

1 to 2 hours

A patient is required to be administered vancomycin for treatment of an abdominal abscess. What should the nurse ensure when monitoring the IV infusion of vancomycin in the patient when caring for him?

Administer each dose over 60 minutes.

The nursing instructor is discussing the administration of azithromycin, a macrolide, with her clinical group. The instructor asks her students to identify the medication that will decrease the effects of azithromycin when administered concurrently. Which of the following medications would the students identify?

Antacids

A patient has been administered linezolid. The patient is fond of eating chocolates and coffee, both of which contain tyramine. What should the nurse inform the patient about the risk involved when linezolid interacts with foods containing tyramine?

Causes severe hypertension.

A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?

Culture tests

Daptomycin (Cubicin) can be used to treat which type of bacterium?

Gram-positive bacteria

A common reaction associated with the intravenous administration of vancomycin is "red man syndrome." What is the cause of red man syndrome?

Histamine release

An 82-year-old client, who lives alone and has occasional memory lapses, is being seen by the home health nurse. In reviewing the client's medication, the nurse discovers that the client was recently prescribed azithromycin for urethritis. What characteristic of this drug makes it an appropriate choice for this client?

It is taken only once a day.

A client presents to the health care provider's office with a skin infection on the forearm. The infection is resistant to over-the-counter antibiotics. After receiving the culture and sensitivity results, the provider orders tigecycline. The nurse knows that this client has what illness?

MRSA

Which statement is true concerning macrolides?

Macrolides are bactericidal or bacteriostatic.

A client develops antibiotic-induced colitis. The symptoms have worsened within the past 72 hours. The nurse expects the health care provider to order what medication, which is considered the initial drug of choice?

Metronidazole

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

Nausea, vomiting, and diarrhea

A nurse knows that promoting an optimal response to drug therapy is a desired outcome for clients on fluoroquinolones. One important action the nurse should include in the plan of care is which?

Observe the client for the first 48 hours for adverse reactions to the drug.

A client with an infected ulcer on the foot has been prescribed daptomycin. What action should the nurse ensure has been taken to determine that the drug will be effective in treating the infection?

Obtain a culture of the client's infection.

The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present?

Perform culture and susceptibility tests.

The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?

Red man syndrome