ch 9: antibiotics prep u qs
A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?
"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur." Clients should refrain from excessive intake of foods rich in tyramine, which include cheese and dairy products, beef or chicken liver, beer and ale, red wine, avocados, bananas, figs, raisins, caffeine, and chocolates. Because most people consume these food items, the diet is difficult to maintain
A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy? -A cancer client -An obese 45-year-old man -A new mother who is nursing -An HIV-positive client
-An HIV-positive client they are immunocompromised
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 has had an allergic reaction to a penicillin -Asking the client if she is pregnant -Measuring the client's blood pressure -Asking the client if she is allergic to sulfonamides
-Asking the client if she is pregnant
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? -It causes mutations. -It lowers the pH of cellular contents. -It inhibits cell wall synthesis. -It inhibits protein synthesis.
-It inhibits cell wall synthesis.
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9°F. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first? -Administer sulfasalazine (Azulfidine). -Obtain urine for culture and sensitivity. -Administer acetaminophen for temperature. -Provide client with eight ounces of fluid.
-Obtain urine for culture and sensitivity.
A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety? -supplementing the antibiotic with vitamin K -changing to a different antibiotic -increasing the dose of rifaximin -changing to parenteral administration of rifaximin
-changing to a different antibiotic
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is to mixed yielding 250 mg/15 mL. How many mL should be drawn up in the syringe?
45 mL
Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Kidneys GI/GU tract Lymph nodes All the above
All the above Tuberculosis is an infectious disease that usually affects the lungs but may involve most parts of the body, including lymph nodes, meninges, bones, joints, kidneys, and the gastrointestinal tract
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? -If a dosage is missed, increase the next dosage to meet the daily quota. -Take drug on an empty stomach, an hour before or 2 hours after meals. -Ampicillin will reduce the effectiveness of birth control pills. -Avoid use of skin care products, like moisturizers, when on penicillin therapy.
Ampicillin will reduce the effectiveness of birth control pills.
A client taking Bactrim DS one tablet twice daily for 14 days should be counseled about which of the following adverse reactions? Select all that apply. Anorexia Photosensitivity Blurred vision Muscle pain Crystalluria
Anorexia Photosensitivity Crystalluria adverse reactions to sulfonamide include nausea, vomiting, anorexia, stomatitis, chills, fever, crystalluria, and photosensitivity
A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods? Citrus fruits Cheese, dairy products, and bananas Potatoes and root vegetables Chicken and fish
Cheese, dairy products, and bananas
A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI? Trichomoniasis Chlamydia Human papillomavirus Vaginitis
Chlamydia
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 a sulfonamide for treatment? -Has the child taken a corticosteroid for treatment? -Has the child taken tetracycline for treatment? -Has the child taken a cephalosporin for treatment?
Has the child taken tetracycline for treatment?
A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient? Monitoring fluid intake. Testing for increased glucose levels. Testing for occult blood. Monitoring blood creatinine levels.
Monitoring blood creatinine levels.
The nurse is providing care to a client who is receiving an aminoglycoside and cephalosporin. Which assessment is a priority of care? Increased bleeding Nephrotoxicity Respiratory difficulty Nausea
Nephrotoxicity
When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions? Hypoglycemia and hyperglycemia Ototoxicity and nephrotoxicity Liver necrosis, or hepatic failure Glaucoma and renal failure
Ototoxicity and nephrotoxicity
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? Photosensitivity Muscle cramping Weakness Fatigue
Photosensitivity
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client? Rifampin and Pyrazinamide Dapsone and isoniazid Rifampin and isoniazid Pyrazinamide and dapsone
Rifampin and isoniazid
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? -Avoid foods high in sodium such as processed meats. -Take precautions to prevent photosensitivity. -Take a missed dose, even if close to the next dose. -Take the necessary vitamins along with the drug.
Take precautions to prevent photosensitivity.
The nurse understands that which is the highest priority when teaching about antitubercular medications? Staying hydrated Taking medications as prescribed Monitoring sputum Eating a well balanced diet
Taking medications as prescribed
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? Nausea Abdominal pain Swelling and itching of the throat Vaginal itching and discharge
Vaginal itching and discharge
A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component? fluids calories proteins vitamin D
fluids
tetracycline is effective for treating what three conditions
mycoplasma chlamydia rickettsia
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? intravenous (IV) intramuscular (IM) subcutaneous (SQ) oral (PO)
oral (PO)
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client? -"You might develop a mild fever when you finish your antibiotics, but that doesn't mean your infection has returned." -"Remember to have your required blood work drawn in 48 hours." -"It's possible that your urine might be pink-tinged for the next little while, but that's expected and it will resolve." -"Make sure to avoid drinking any alcohol for the next three days."
"Make sure to avoid drinking any alcohol for the next three days."
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) -Thrombocytopenia -Anaphylactic shock -Leukopenia
-Stevens-Johnson syndrome (SJS) Clients with Stevens-Johnson syndrome (SJS) may report fever, cough, muscular aches and pains, and headache. Additional signs include lesions on the neck and mouth. Lesions are not symptoms of leukopenia or anaphylactic shock. A client with thrombocytopenia develops bruises on the skin but not lesions in the form of red wheals.
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 Increased absorption Increased elimination Decreased elimination
Decreased absorption Antacids, iron salts and zinc can cause decreased absorption of the antibiotic. There is no affect on elimination of the antibiotic.
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. -Contraindicated in clients with renal dysfunction -Can be used to treat acne vulgaris -May cause visual disturbances -Can be used in clients allergic to penicillins -Broad-spectrum antibiotics
-can be used to treat acne vulgaris -May cause visual disturbances -Can be used in clients allergic to penicillins -Broad-spectrum antibiotics
Which statement is true in regards to the oral administration of tetracyclines? -Tetracyclines should only be administered in the morning. -Tetracyclines should only be administered in the evening. -Tetracyclines should be administered on a full stomach. -Tetracyclines should be administered with a full glass of water
Tetracyclines should be administered with a full glass of water
beta-lactam antibacterial drugs MOA
inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes
Tetracyclines should not be used in children younger than 8 years of age because of their effects on: kidneys. teeth and bones. blood. liver.
teeth and bones.
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic? -The client has a known latex allergy -The client has chronic renal failure -The client has a history of not adhering to treatment -The client has type 2 diabetes, controlled with oral antihyperglycemics
-The client has chronic renal failure
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? -Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. -Continue to take the medication as prescribed; these are expected side effects from the medication. -These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. -Stop the medication and the health care provider will order you a different antibiotic.
-These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.
The nurse knows that tuberculosis (TB) is an infectious disease seen around the world and in many cases due to overcrowding. The nurse would be aware of this condition if the lab reports showed which bacteria? Escherichia coli Mycobacterium tuberculosis Clostridium difficile Staphylococcus aureus
Mycobacterium tuberculosis