Karch Focus on Pharmacology Chapter 9- Antibiotics

Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Lymph nodes GI/GU tract Kidneys All the above

All of 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.

Aminoglycosides

The aminoglycosides are bactericidal. They inhibit protein synthesis in susceptible strains of Gram-negative bacteria

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? "My IV site feels really itchy a lot of the time." "I definitely feel like my appetite has suffered since I started these antibiotics." "I've got this pounding headache that never seems to go away." "I feel like I'm having trouble hearing the last little while."

"I feel like I'm having trouble hearing the last little while." Gentamicin is associated with serious and possibly irreversible ototoxicity, which must be addressed immediately. For this reason, it is a priority over anorexia, headache, or pruritus at the IV site.

After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following? "I only need to take one pill every day for this medicine to work." "I need to take the medicine with a meal so I don't get an upset stomach." "I should drink a full 8-oz glass of water when I take the medicine." "I might have some bloody diarrhea after using this medicine."

"I should drink a full 8-oz glass of water when I take the medicine." Food in the stomach decreases the absorption of oral macrolides such as erythromycin. Therefore, the drug should be taken on an empty stomach with a full, 8-oz glass of water, 1 hour before or at least 2 to 3 hours after meals. The client may experience diarrhea with this drug, but it should not be bloody. Bloody diarrhea is associated with pseudomembranous colitis, which needs to be reported to the health care provider immediately. Due to its long half-life, azithromycin is usually ordered as a once-daily dose.

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." "Make sure to avoid drinking any alcohol for the next three days." "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." To avoid a disulfiram-like reaction when alcohol and cephalosporins are used together, the client should avoid consuming alcoholic beverages for at least 72 hours after completing the drug course. Pink-tinged urine is not expected and a fever would be clinically significant. There is not normally any need for follow-up blood work.

Antibiotics are made in 3 ways:

1) living microorganisms 2) synthetic manufacture 3) genetic engineering

Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Lymph nodes Kidneys GI/GU tract All the above

All of 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 nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy? An obese 45-year-old man A new mother who is nursing An HIV-positive client A cancer client

An HIV-positive client The nurse should pay special attention to the HIV-positive client because this client will require rifampin therapy for a longer period of time than the other clients. An HIV-positive person is immunocompromised, and it will take longer to fight the infection. This could increase the difficulty of adherence to the drug regimen. In addition, many of the drugs used to treat HIV are contraindicated in clients who take rifampin. Rifampin can be safely administered to nursing mothers, those with cancer, and people over 65 given certain conditions. However, their therapy should not be longer than normally required unless complications occur.

What are the major classes of antibiotics?

Antibiotics that act against cell wall synthesis Antibiotics affecting the cell membrane Antibiotics inhibiting protein synthesis: Aminoglycosides Antibiotics that inhibit nucleic acid synthesis Metabolic inhibitors major classes of antibiotics: Aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins and penicillinase-resistant drugs, sulfonamides, tetracyclines, and the disease-specific antimycobacterials, including the antitubercular and leprostatic drugs

A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity? Cefadroxil Kanamycin Ketoconazole Lactulose

Cefadroxil Cefadroxil is a cephalosporin. Administration of cephalosporins or carbapenems should be avoided if possible in people with life-threatening allergic reactions to penicillin. Lactulose reduces blood ammonia by resident intestinal bacteria. It is not contraindicated in the event of penicillin anaphylaxis. Ketoconazole is an antifungal and does not possess cross-sensitivity to penicillin. Kanamycin is an aminoglycoside and does not possess cross-sensitivity to penicillin.

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? Urinalysis Ulcer tests Culture tests Stool tests

Culture tests The nurse should check whether culture tests are conducted before the first dose of drug is administered to the client.

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 Decreased elimination Increased absorption Increased 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 client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? Administer oral diphenhydramine to the client during the infusion. Administer an STAT dose of acetylcysteine. Slow down the rate so that the infusion takes place over 2 hours. Discontinue the infusion and inform the health care provider promptly.

Discontinue the infusion and inform the health care provider promptly. Severe hypersensitivity reactions have occurred with the administration of fluoroquinolones. The nurse discontinues the antibiotic immediately if skin rash or other signs or symptoms occur.

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 2 L of fluid per day. Avoid all caffeine and alcohol. Minimize sodium intake.

Drink at least 2L of fluid per day Clients should be encouraged to drink a lot of fluids and maintain nutrition, even though nausea, vomiting, and diarrhea may occur. There is no need to eliminate red meat, seafood, caffeine, or alcohol from the diet, although alcohol may increase the risk of GI irritation. There is no need to minimize sodium intake.

A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause? Drug-resistant tuberculosis Methicillin-resistant Staphylococcus aureus Vancomycin-resistant Staphylococcus aureus Human immunodeficiency virus

Drug-resistant tuberculosis A client who is being treated with antitubercular drug therapy and is not responding to the medication regime is most likely experiencing drug-resistant tuberculosis. Human immunodeficiency virus causes tuberculosis to move more rapidly. This scenario does not provide any indication that the tuberculosis is related to the diminished client response. The scenario does not identify methicillin-resistant or vancomycin-resistant Staphylococcus aureus.

The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe? Loxapine hydrochloride Pravastatin Erythromycin Meclizine

Erythromycin Erythromycin is the prototype macrolide used to treat Legionnaires disease. Loxapine hydrochloride is an antipsychotic agent. Meclizine is used to treat nausea and dizziness. Pravastatin is used to treat hypercholesterolemia.

Which of the following drugs would be classified as an aminoglycoside?

Gentamicin Gentamicin is classified as an aminoglycoside. Levofloxacin is a fluoroquinolone; clarithromycin is a macrolide; and cefaclor is a cephalosporin.

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 corticosteroid for treatment? Has the child taken tetracycline for treatment? Has the child taken a sulfonamide for treatment? Has the child taken a cephalosporin for treatment?

Has the child taken tetracycline for treatment? Tetracycline administered to a child between the ages of 4 months and 8 years will stain the permanent teeth.

A client is diagnosed with latent tuberculosis infection. The nurse expects that the treatment plan will include which drug? INH Pyrazinamide Cyclosporine Ethambutol

INH INH is the treatment of choice for LTBI.

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. It lowers the pH of cellular contents. It causes mutations. It inhibits protein synthesis.

It inhibits cell wall synthesis. Beta-lactam antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes. Penicillin V does not inhibit protein synthesis. Penicillin V does not inhibit protein synthesis, cause mutations, or lower the pH of a bacterium's cellular contents.

What is the rationale for not administering tetracycline to children under the age of 8 years? It will increase the risk for future infections. It will increase the risk of heart failure. It will interfere with enamel development. It will not treat the infection effectively.

It will interfere with enamel development. Tetracyclines should not be used in children younger than 8 years because of their effects on teeth and bones. In teeth, the drugs interfere with enamel development. Without existing contraindications, tetracycline can be used in children to treat infections without increasing the risk of heart failure. The administration of tetracycline will not increase the risk of future infections in children.

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication? Arthralgia Fever Jaundice Weight gain

Jaundice Potentially serious adverse effects of INH include hepatotoxicity. Hepatotoxicity may be manifested by symptoms of hepatitis (e.g., anorexia, nausea, fatigue, malaise, jaundice) or elevated liver enzymes. The nurse reports their development to the health care provider promptly to prevent possible liver failure and death.

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication? Weight gain Arthralgia Fever Jaundice

Jaundice Potentially serious adverse effects of INH include hepatotoxicity. Hepatotoxicity may be manifested by symptoms of hepatitis (e.g., anorexia, nausea, fatigue, malaise, jaundice) or elevated liver enzymes. The nurse reports their development to the health care provider promptly to prevent possible liver failure and death. Weight gain, fever, and arthralgia are not the most known adverse effects of INH.

The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease is which? listeriosis. leptospirosis. leprosy. cholera.

Leprosy, also referred to as Hansen's disease, is caused by the bacterium Mycobacterium leprae.

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test? Hematocrit Serum albumin CBC Liver function

Liver function Aztreonam, imipenem, meropenem, and ertapenem may cause abnormalities in liver function test results (i.e., elevated alanine and aspartate aminotransferases [ALT and AST] and alkaline phosphatase), but hepatitis and jaundice rarely occur.

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? Testing for increased glucose levels. Testing for occult blood. Monitoring fluid intake. Monitoring blood creatinine levels.

Monitoring blood creatinine levels. An elderly patient is more susceptible to the nephrotoxic effects of the cephalosporins. Since renal impairment is present, it is important for the nurse to closely monitor the patient's 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? Chest pain Nausea Hypotension Excessive tearing

Nausea The most common adverse reactions that are caused due to cephalosporin administration include nausea, vomiting, and diarrhea. Cephalosporin does not cause hypotension, chest pain, or excessive tearing; hypotension and chest pain are some of the adverse reactions of disulfiram.

The nurse should monitor the client for which common side effects of erythromycin therapy? Urticaria and ophthalmic drainage Headache and fever Shortness of breath and sore throat Nausea, vomiting, and diarrhea

Nausea, vomiting, and diarrhea Gastrointestinal problems (e.g., nausea, vomiting, and diarrhea) are common side effects of erythromycin and other macrolides. Headache, fever, ophthalmic drainage, urticaria, shortness of breath and sore throat are no common side effects.

When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route? Subcutaneous Topical Intramuscular Oral

Oral Most fluoroquinolones are administered orally; levofloxacin and moxifloxacin may also be given intravenously.

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

Ototoxicity and nephrotoxicity After parenteral administration, aminoglycosides are widely distributed in extracellular fluid and reach therapeutic levels in blood, urine, bone, inflamed joints, and pleural and ascitic fluids. They accumulate in high concentrations in the proximal renal tubules of the kidney leading to acute tubular necrosis. This damage to the kidney is termed nephrotoxicity. They also accumulate in high concentrations in the inner ear, damaging sensory cells in the cochlea and the vestibular apparatus. This damage to the inner ear is termed ototoxicity.

Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies? Cephalosporin Penicillin Tetracycline Vancomycin

Penicillin Penicillin G may also be used as prophylaxis in special patient populations to prevent bacterial endocarditis prior to procedures likely to produce temporary bacteremia, such as dental procedures. These patients include those with prosthetic heart valves, mitral valve prolapse, most congenital heart diseases, and acquired valvular heart disease. It may also be used as prophylaxis in patients with recurrent rheumatic fever or rheumatic heart disease.

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for? Abdominal pain Blood dyscrasias Photosensitivity Cramping

Photosensitivity Demeclocycline causes photosensitivity reactions. Abdominal pain and cramping are adverse reactions of macrolides. Blood dyscrasias is an adverse reaction of lincosamides.

The nurse should advise clients that which of the following are adverse reactions that may occur with the administration of tetracyclines? Select all that apply. Photosensitivity Hypoglycemia Hypotension Diarrhea Stomatitis

Photosensitivity Diarrhea Stomatitis The nurse should advise clients nausea, vomiting, diarrhea, epigastric distress, stomatitis, sore throat, skin rashes, and photosensitivity are adverse reactions that may occur with the administration of tetracyclines.

The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system? Hepatic Splenic Renal Pancreatic

Renal Sulfonamides should be administered with great caution in the older adult because of age-related, decreased renal function. Though hepatic function may diminish related to age, it is not a caution to sulfonamide therapy. The same is true for pancreatic and splenic function.

A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client? Renal damage Liver toxicity Bone marrow depression Congestive heart failure

Renal damage Renal impairment is a possible side-effect to the administration of SMZ-TMP. It does not cause liver toxicity, bone marrow depression, or congestive heart failure.

A client has been infected with Mycobacterium avium complex from an indoor pool. Which medication is the recommended antitubercular used to treat MAC? Clarithromycin (Biaxin) Azithromycin (Zithromax) Rifabutin (Mycobutin) Isoniazid (INH)

Rifabutin (Mycobutin) Rifabutin (Mycobutin) is the antitubercular medication administered for Mycobacterium avium complex. Clarithromycin and azithromycin are macrolides administered for Mycobacterium avium complex.

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? Serum BUN and creatinine levels Complete blood count Coagulation studies Signs of disulfiram-like reaction

Serum BUN and creatinine levels The nurse would need to assess renal function indicated by serum BUN and creatinine levels because combining cephalosporins with aminoglycosides increases the client's risk for renal toxicity.

A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence? A type I hypersensitivity reaction The fact that the client may have chewed the capsules prior to swallowing them Superinfection following the eradication of normal oral flora A delayed (type IV) hypersensitivity reaction

Superinfection following the eradication of normal oral flora Candida superinfections may result from the use of tetracycline. The superinfection results from the elimination of normal flora and is not a hypersensitivity reaction.

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? Take the drug on an empty stomach. Take the drug along with milk or fruit juice. Take the drug along with a meal. Take the drug immediately after meals.

Take the drug on an empty stomach. Oral preparations of tetracycline should be administered on an empty stomach with a full glass of water to maximize absorption. Tetracycline is not absorbed effectively if taken with food, dairy products, or immediately after meals.

What is an important precaution of fluoroquinolones that should be included in the client teaching? Vomiting Photosensitivity Hypertension Tendon rupture

Tendon rupture Tendonitis and tendon rupture risk increases with the use of a fluoroquinolone. Common adverse effects of fluoroquinolones include nausea, vomiting, diarrhea, headache, abdominal pain or discomfort, dizziness, and 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 type 2 diabetes, controlled with oral antihyperglycemics 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 chronic renal failure Renal failure would preclude the use of an aminoglycoside. Nonadherence must always be addressed, but this client variable is not specific to aminoglycosides. Neither latex allergies nor type 2 diabetes would necessarily rule out the use of an aminoglycoside.

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples? Jaundice Nausea and diarrhea Hemolysis Urinary tract infections

Urinary tract infections Cephalosporins are used to treat urinary tract infections, skin infections, and hospital-acquired pneumonias. Cephalosporins are not used to treat hemolysis or jaundice. Nausea and diarrhea are some of the adverse reactions that can occur when a patient is on cephalosporins therapy.

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? Swelling and itching of the throat Nausea Abdominal pain Vaginal itching and discharge

Vaginal itching & discharge A vaginal infection in a client who is taking amoxicillin is an example of a superinfection.

The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects? Headache and dizziness Phlebitis Superinfections Vomiting and diarrhea

Vomiting and diarrhea Although headache and dizziness, superinfections, and phlebitis (with intravenous administration) can occur, the most common adverse effects of cephalosporins involve the GI tract and include vomiting, diarrhea, nausea, anorexia, abdominal pain, and flatulence.

A client is receiving gentamicin to treat meningitis. The health care provider has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn? 09:00 10:00 12:00 08:00

With conventional dosing, it is necessary to take gentamicin peak levels 30 minutes after the end of a 30-minute IV infusion. Thus, 08:00 is the optimal peak time to assess the serum level of gentamicin.

The nurse is providing health education to a client prescribed isoniazid. What should the nurse instruct the client to avoid? direct sunlight dairy products alcohol foods containing purine

alcohol Alcohol increases the risk of hepatotoxicity with isoniazid even if alcohol use is stopped during therapy. There is no therapeutic reason for clients taking isoniazid to avoid sunlight, dairy products, or purine.

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? amoxicillin ibuprofen ciprofloxacin neomycin-polymyxin B

amoxicillin Amoxicillin is the drug of choice for a client with acute otitis media. -Ciprofloxacin is prescribed for necrotizing otitis external. -Ibuprofen is over the counter and does not require a prescription; although it can be used for pain associated with acute otitis media, it will not treat the infection. -Neomycin-polymyxin B is used for external otitis media.

Gram-negative

bacteria that accept a negative stain and are frequently associated with infections of the genitourinary or gastrointestinal (GI) tract

Aerobic

bacteria that depend on oxygen for survival

Anaerobic

bacteria that survive without oxygen, which are often seen when blood flow is cut off to an area of the body

A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy? baseline serum glucose levels baseline renal function values baseline bone mass determination baseline liver function test values

baseline liver function test values For a TB client, the nurse should obtain baseline liver function test values and schedule serial liver function tests throughout therapy. In addition, a nurse should ensure a baseline A1C evaluation for clients who are diabetics, because INH may cause hyperglycemia.

Antibiotic

chemical that is able to inhibit the growth of specific bacteria or cause the death of susceptible bacteria

Synergistic

drugs that work together to increase drug effectiveness

Carbapenems

effective against Gram-positive and Gram-negative bacteria The carbapenems are bactericidal. They inhibit cell membrane synthesis in susceptible bacteria, leading to cell death They are indicated for treating serious intra-abdominal, urinary tract, skin and skin structure, bone and joint, and gynecological infections.

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example? metronidazole ciprofloxacin gemifloxacin levofloxacin

metronidazole Metronidazole is not an example of a fluoroquinolone. Ciprofloxacin is an example of a fluoroquinolone. Levofloxacin is an example of a fluoroquinolone. Gemifloxacin is an example of a fluoroquinolone.

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? subcutaneous (SQ) oral (PO) intravenous (IV) intramuscular (IM)

oral (PO) While ciprofloxacin is typically administered by the PO or IV route, in most cases, oral administration is used. The medication is not administered by either the SQ or IM routes.

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: fats in her diet. alcohol. nicotine. oral contraceptives.

oral contraceptives. The nurse should document the method of birth control used by a woman of childbearing age because antibiotics, such as penicillin G, can counteract the effects of an oral contraceptive. The client should be advised to use a backup method of birth control for the duration of the therapy. Excess fats in the diet, alcohol, and nicotine should be avoided, but pose no special risk when used along with penicillin G.

The nurse has administered the first dose of a client's newly-prescribed penicillin. What assessment finding should the nurse interpret as adverse effect that suggests a more serious concern? drowsiness decrease in blood pressure from 128/77 mm HG preadministration to 119/70 postadministration rash to the face and trunk new onset of pain

rash to the face and trunk A rash poses no threat in and of itself but suggests the possibility of drug intolerance or hypersensitivity. A modest decrease in blood pressure or level of consciousness would be less clinically significant. The nurse must address the client's pain, but this is unlikely to be a consequence of antibiotic use.

The nurse is teaching a client receiving cephalosporin therapy about events to immediately report to the healthcare provider. The nurse determines that the teaching was successful when the client identifies which sign(s)/symptom(s)? Select all that apply. dysuria skin rash abdominal pain vomiting severe diarrhea

severe diarrhea abdominal pain vomiting The client should be instructed to notify the primary health care provider immediately should one or more occur: abdominal pain, diarrhea, anorexia, flatulence, gastritis, nausea, and vomiting. A skin rash and dysuria are not recognized as potential adverse effects to cephalosporins.

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug? dizziness tachycardia polydipsia skin rash or itching

skin rash or itching Clients taking sulfonamides should be instructed to contact the prescriber if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced allergic reaction and the need to change or stop the drug.

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug? tachycardia dizziness skin rash or itching polydipsia

skin rash or itching Clients taking sulfonamides should be instructed to contact the prescriber if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced allergic reaction and the need to change or stop the drug.

A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as: allergy. skin rash. superinfection. anaphylactic reaction. allergic reaction.

superinfection. Prolonged use of otic preparations containing an antibiotic may result in a superinfection (an overgrowth of bacterial or fungal microorganisms not affected by the antibiotic being administered).

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug

with a glass of water 1 hour before or 2 hours after a meal. The nurse should instruct the parents to administer penicillin V exactly as prescribed at regular intervals. Penicillin V should be taken on an empty stomach 1 hour before or 2 hours after a meal with a glass of water. Penicillin V should not be taken with meals because food may affect the absorption of the drug.

A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform? Instruct the patient to gargle every two hours. Offer patient a liquid diet. Inspect mouth and gums regularly. Instruct patient to avoid brushing teeth.

Inspect mouth and gums regularly. The nurse should regularly inspect the patient's mouth and gums to assess the patient's progress. The nurse should instruct the patient to use a soft-bristled toothbrush. The patient need not follow a liquid diet; a nonirritating soft diet can be recommended. Gargling every two hours may not help relieve the symptoms and may even aggravate the existing condition.

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 blood creatinine levels. Testing for occult blood. Monitoring fluid intake. Testing for increased glucose levels.

Monitoring blood creatinine levels. An elderly patient is more susceptible to the nephrotoxic effects of the cephalosporins. Since renal impairment is present, it is important for the nurse to closely monitor the patient's blood creatinine levels. The nurse should conduct a test for occult blood if blood and mucus occur in the stool and monitor the fluid intake if there is a decrease in urine output. The nurse does not need to monitor for increased glucose levels unless the patient has a history of diabetes.

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. alcohol. nicotine. fats in her diet.

Oral contraceptives The nurse should document the method of birth control used by a woman of childbearing age because antibiotics, such as penicillin G, can counteract the effects of an oral contraceptive. The client should be advised to use a backup method of birth control for the duration of the therapy. Excess fats in the diet, alcohol, and nicotine should be avoided, but pose no special risk when used along with penicillin G.

A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject? The need to match drug dosages carefully to signs and symptoms The fact that nonadherence will necessitate the use of antiretrovirals The fact that nonadherence to treatment exacerbates the risks of adverse effects The need to consistently take the prescribed drugs in order to cure TB

The need to consistently take the prescribed drugs in order to cure TB Consistent adherence to treatment is imperative to ensure successful treatment of TB. Nonadherence leads to resistance and unsuccessful treatment, not increased adverse effects.

Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment? The patient will require intramuscular, rather than oral, administration of INH. The patient will require positive-pressure isolation because he will be immunocompromised. The patient will require oral antihyperglycemics because exogenous insulin will be contraindicated. The patient will require vigilant monitoring of blood glucose levels.

The patient will require vigilant monitoring of blood glucose levels. INH treatment constitutes a risk for hyperglycemia and close monitoring of blood glucose levels is thus indicated. This patient's history will not likely impact the chosen route for the drug and insulin therapy can be safely continued. The patient will be vulnerable to other infections for the foreseeable future, but he will not likely be immunocompromised to the degree that positive-pressure isolation is required.

Gram-positive

bacteria that take a positive stain and are frequently associated with infections of the respiratory tract and soft tissues

A client diagnosed with Chlamydia is allergic to penicillin. What medication could be used as a substitute for penicillin in this situation? tetracycline erythromycin doxycycline chloramphenicol

erythromycin Erythromycin is used as a penicillin substitute in clients who are allergic to penicillin and for prevention of rheumatic fever, gonorrhea, syphilis, pertussis, and chlamydial conjunctivitis in genitourinary infections caused by Chlamydia trachomatis and intestinal amebiasis caused by Entamoeba histolytica. None of the other options are typically used as a substitute to account for an allergy to penicillin when treating chlamydia.