Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones

The client has been diagnosed with a serious infection caused by gram-negative aerobic bacilli. The client has been prescribed IV gentamicin. What statement by the client should the nurse follow up most promptly? "I've got this pounding headache that never seems to go away." "I definitely feel like my appetite has suffered since I started these antibiotics." "I feel like I'm having trouble hearing the last little while." "My IV site feels really itchy a lot of the time."

"I feel like I'm having trouble hearing the last little while."

Which of the following drugs is likely to be administered as a first-line treatment for anthrax exposure? Ciprofloxacin Tobramycin Gentamicin Norfloxacin

Ciprofloxacin

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 elimination Increased absorption Increased elimination Decreased absorption

Decreased absorption

The nurse is providing client teaching before discharging a client home. The client is taking ciprofloxacin. What action should the nurse encourage the client to prioritize? Eliminate red meat and seafood from the diet. Drink at least 2L of fluid per day. Avoid all caffeine and alcohol. Minimize sodium intake.

Drink at least 2L of fluid per day.

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? Penicillins Cephalosporins Fluoroquinolones Sulfonamides

Fluoroquinolones

Which of the following classes of antibiotics is a direct inhibitor of DNA synthesis in bacteria? Ketolides Macrolides Fluoroquinolones Penicillins

Fluoroquinolones

After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class? Tobramycin Kanamycin Gentamicin Neomycin

Gentamicin

Which of the following drugs would be classified as an aminoglycoside? Cefaclor Clarithromycin Levofloxacin Gentamicin

Gentamicin

A 60-year-old male client with a diagnosis of bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in the client's condition and the effect of the drug treatment on his blood cultures. During morning care, the client has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this client? Document the client's reports and integrate them into his plan of care. Continue the gentamicin as ordered and monitor the client's symptoms closely. Hold the next scheduled dose of gentamicin until the health care provider has been consulted. Administer the next scheduled dose of gentamicin over 90 to 120 hours.

Hold the next scheduled dose of gentamicin until the health care provider has been consulted.

What is a contraindication to use of a fluoroquinolone? Weight Lactation Gender Height

Lactation

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions? Glaucoma and renal failure Liver necrosis, or hepatic failure Ototoxicity and nephrotoxicity Hypoglycemia and hyperglycemia

Ototoxicity and nephrotoxicity

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions? Liver necrosis, or hepatic failure Glaucoma and renal failure Hypoglycemia and hyperglycemia Ototoxicity and nephrotoxicity

Ototoxicity and nephrotoxicity

A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order? A complete blood count every 48 hours A serum albumin determination every 48 hours Measurement of electrolytes every 48 hours Peak and trough serum levels

Peak and trough serum levels

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? Muscle cramping Weakness Photosensitivity Fatigue

Photosensitivity

The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize? Muscle strength Gastrointestinal function Nutritional status Renal function

Renal function

A client scheduled to undergo major abdominal surgery has been prescribed preoperative neomycin. Neomycin is used preoperatively for what reason? Suppress intestinal bacteria. Produce ammonia. Sterilize the incision site Enhance intestinal flora

Suppress intestinal bacteria

A client scheduled to undergo major abdominal surgery has been prescribed preoperative neomycin. Neomycin is used preoperatively for what reason? Enhance intestinal flora Suppress intestinal bacteria. Sterilize the incision site Produce ammonia.

Suppress intestinal bacteria.

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. Take the necessary vitamins along with the drug. Take a missed dose, even if close to the next dose. Avoid foods high in sodium such as processed meats.

Take precautions to prevent photosensitivity.

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 history of not adhering to treatment The client has type 2 diabetes, controlled with oral antihyperglycemics The client has a known latex allergy The client has chronic renal failure

The client has chronic renal failure

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 type 2 diabetes, controlled with oral antihyperglycemics The client has chronic renal failure The client has a known latex allergy The client has a history of not adhering to treatment

The client has chronic renal failure

Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order? Complete blood count White blood count Culture and sensitivity Electrolyte panel

White blood count

The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse? "That is the medication working. Continue to take as directed." "You are experiencing an adverse affect of the medication. Those symptoms will decrease over time." "You are allergic to the medication. Stop taking it immediately." "You may be experiencing an additional infection. I will discuss this with your health care provider."

You may be experiencing an additional infection. I will discuss this with your health care provider."

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? antidiabetic agents antacids antihypertensives oral contraceptives

antacids

When describing the action of fluoroquinolones to treat infection to a group of nursing students, which action would the instructor most likely include? bacteriostatic fungicidal bactericidal fungistatic

bactericidal

A local bioterrorism medical team is responding to a possible anthrax attack. The team is instructed that a fluoroquinolone may be used to treat exposure to anthrax. The nurse should prepare to administer what antibiotic? finafloxacin amoxicillin gemifloxacin ciprofloxacin

ciprofloxacin

A client is prescribed ciprofloxacin 500 mg PO twice a day. When would the nurse most likely administer the drug? once daily PO, 4 hours after the meal every 12 hours IV without regard to the meal once daily IM without regard to the meal twice daily PO, 2 hours after the meal

once daily PO, 4 hours after the meal

A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment? breath sounds and oxygen saturation visual acuity muscle strength and coordination urine output and BUN and creatinine levels

urine output and BUN and creatinine levels

The nurse should monitor a client for which finding when aminoglycosides are administered concomitantly with furosemide? Select all that apply. vertigo hematuria proteinuria numbness tinnitus

vertigo tinnitus