Pharm ch 38- 39 Antibiotics

Which instruction would the nurse give a patient about allergic reaction to an antibacterial drug?

" Stop taking the medication immediately at the first sign of an allergic reaction"

which question would the nurse ask the patient before administering

" did you consume alcohol in the past 24 hours" the nurse would ask about alcohol before administering metronidazole because it causes potential drug interactions

Which advice would the nurse provide to a patient taking neomyicin to prevent drug-induced superinfections?

" eat yogurt" Drinking milk, eggs and leafy veggies does not help prevent antibiotics-associated superinfections induced by neomycin

which information would the nurse include in the teaching plan for a patient who is prescribed ciprofloxacin and is also taking an antacid?

" take the antacid 2 hours before the drug" Ciprofloxacin chelates(binds) with divalent mineral in antacids and this interaction decreases the absorption of ciprofloxacin

Which statement is the priority instruction for the nurse to give to a patient with a history of kidney stones who has just been prescribed sulfamethoxazole/trimethoprim?

" take this medication with a full glass of fluid"

Which instruction would the nurse give a patient about administering topical clindamycin?

"Apply a thin layer to the effected are after it has been cleansed"

which instruction does the nurse give to the patient to prevent complication associated with sulfamethoxazole/trimethoprim SMZ-TMP?

"Avoid exposure to sunlight" The nurse would instruct the patient to avoid exposure to sunlight during sulfonamide therapy because it may cause a photosensitivity reaction pr another type of skin reaction in the patient. the nurse would instruct the patient to increase fluid intake to reduce risk of crystalluria.

which instruction does the nurse give to the patient to ensure safe and effective administration of demeclocycline?

"avoid the consumption of dairy products"

Which instruction to a patient prescribes nitrofurantoin is most important to facilitate adherence to the therapeutic regimen?

"take the medication with meals or milk" Gastrointestinal disturbance such as anorexia and vomiting are common during nitrofurantoin therapy. the nurse instructs the patient to take this medication with food, milk or fluid to decrease those symptoms

which statement by the nurse explains the mechanism of bacteriostatic action of tetracycline?

"tetracycline inhibits protein synthesis"

Which statment will the nurse make to a patient prescibed azithromycin who expresses concern regarding potential gastrointestinal upset similar to that previously experienced when taking erythromycin?

"this drug is like erythromycin but had less severe gastrointestinal side effects" Azithromycin has longer duration as well as fewer and less severe gastrointestinal side effects than erythromycin

which instruction does the nurse give to the patient before the administration of sulfamethoxazole/trimethoprin (SMZ-TMP)

"use any other method other than oral conraception for birth control"

Which question would the nurse ask the patient to determine the cause of an unimproved infection after a patient has completed a course of tetracycline?

"were you using iron supplements while taking the drug?"

which patient would the nurse monitor for atypical signs of infection?

- a 78 year old patient with urinary incontinence - a 35 year old patient who underwent a renal transplant - A 55 year old patient who received radiation for lung cancer

Which instruction would the nurse provide to a patient taking doxycycline daily for the treatment of acne to prevent complications?

- avoid midday sun - consume yogurt daily -use an alternate form of birth control - the drug can also affect natural intestinal flora so the nurse would tell the patient to consume yogurt, Antibitotics can interfere with oral contraceptives, lead to nurse instruct to use an alternate form of birth control.

Which finding in the patient who has been taking antibiotics for a week would indicate the need for referral to the primary health care provider?

- jaundice -excessive fatigue -elevated temperature

Which parameter needs to be assessed to ensure safe drug administration of azithromycin?

- liver function -baseline hearing status -base cardiac function Azithromycin is a macrolide antibiotic

Which information would the nurse include about the adverse effects when educating a patient who is newly prescribed erythromycin for an ear infection?

- palpitation -nausea and vomiting - jaundice

Which finding does the nurse report to the primary health care provider to prevent complications from taking sulfamethoxazole/ tomethoprim(SMZ-TMP)

-Diarrhea -blood in the urine -Shortness of breath

which over the counter drugs will the nurse advise a patient to avoid while the patient is taking doxycycline?

-calcium citrate - magnesium citrate

which infection is treated with metronidazole?

-protozoans -clostridium - bacteroides -streptococcus

Which solution would the nurse administer with quinupristin?

5% dextrose in water (D5W)

What amount of time minimum period that vancomycin may be infused?

60 minutes

the nurse would question the prescription of tetracycline for which patient?

A 6 year old patient with heamophilus influenza. Tetracycline is containdicated in children younger than 8 years old because it can cause permanent discoloration of the teeth. Tetracycline is used to treat rickettsial diseases

Which action would the nurse take after a patient taking sulfonamides reports bruises on the leg and arms?

Asses the patient platelet counts

Which nursing intervention is a necessary priority for a patient with type 2 diabetes mellitus who is started on sulfamethoxazole/trimethoprim?

Assess blood sugar sulfamethoxazole/trimethoprim increases the hypoglycemic response when taken with sulfonylureas(oral hypoglycemic agents). The nurse would assess blood sugar and determine what oral hypoglycemic with patient is taking.

Which infection is indicated for meropenem therapy?

Bacterial meningitis

which action would the nurse take for a patient who is being administered oral sulfamethoxazole/ trimethoprim four time per day?

Call the health care provider to discuss changing the frequency of the dose. The patient should receive sulfamethoxazole/trimethoprim twice a day. the nurse would call the health care provider to clarify this order. the medication should not be scheduled four rime a day.

What antibiotic is the drug of choice for the treatment of anthrax?

Ciprofloxacin

which medication is added to enhance the effectiveness of the ampicillin?

Clavulanic acid

which test would the nurse anticipate for a patient recently treated with antibiotics who has developed watery diarrhea?

Clostridium difficile test

Which infection does the nurse suspect in a patient receiving antibiotics who report abdominal pain and cramps associated with frequent watery stools?

Clostridium infection

Which parameter would the nurse monitor in a patient taking sulfamethoxazole with trimethoprim(SMX-TMP) for a urinary tract infection to prevent complications?

Complete blood count

Which action is the nurse highest priority when discovering a patient started on sulfamethoxazole/ trimethoprim has a viral infection?

Contact the health care provider to discuss the medication

Which food will the nurse instruct the patient to avoid during levofloxacin therapy?

Dairy products

Which term describes the type of antibiotics therapy tailored to treat an identified organism?

Definitive therapy

A patient is diagnosed with a respiratory infection caused by staphylococci. which penicillinase- resistant drug may be included in the prescription?

Dicloxacillin Dicloxacillin is a penicillinase-resistant drug

Which time frame is recommended for alcohol avoidance for a patient taking cefotetan?

During drug therapy and for 3 days afterward

Which medication would the nurse anticipate for a patient who is taking amoxicillin and develops wheezing, difficuty breathing, swealling of the throat and has a fast, irregular pulse on assessment?

Epinephrine The assessment finding makes it evident that the patinet is having a penicillin anaphylactic reaction. epinephrin should be administered to block the action os penicillin

Which microbe is included in the spectrum of antimicrobial activity for the drug amikacin?

Escherichia coli Amikacin is active against Escherichia coli and acinetobacter species

Which medication does the nurse will be prescribed for a patient on long-term antibiotics therapy who complain of watery diarrhea, abdominal pain and has a body temperature of 39.0 (102.2)

Fidaxomicin Fidaxoicin is prescribed for C.difficile

Which antibiotic binds to 30S ribosome to prevent protein synthesis in bacteria?

Gentamicin Aminoglycosides such as gentamicin, bind to ribosomes, specifically the 30S ribosome and thereby prevent protein synthesis in bacteria.

Which biochemical parameter does the nurse assess before administering sulfamethoxazole/trimethoprim(SMZ-TMP)

Red Blood cell count Sulfonamide antibiotics may cause anemia. Therefore, the patients red blood cell count should be assessed before beginning sulfonamide therapy to check the possibility of drug related anemia.

Which function is measured by a patients serum creatine level before starting antibiotic therapy?

Renal Serum creatinine levels would be measured to assess renal function before patient starts anitbiotic therapy.

Which medication may result ineffective of penicillin V potassium?

Rifampin causes drug-drug interaction with penicilllin V potassium it results in poor action of penicillin.

Which adverse effect would the nurse monitor for after administering a dose of imipenem/cilastatin to a patient with postoperative abdominal infection?

Seizure carbapenems such as imipenem/cilastatin can cause drug induced seizure activity.

Which laboratory reports would the nurse evaluate if the patient is administered vancomycin and tobramycin?

Serum creatinie

Which condition is an adverse effect of sulfonamide antibiotics?

Side effects: -urticaria -pancreatitis - hepatotoxicity

Which medication may be ordered to treat ulcerative colitis?

Sulfasalazine Sulfasalazine is the drug of choice for treatment of ulcerative colitis.

Which antibitotic may cause hemolysis in a patient who has glucose-6-phosphate dehydrogenase (G6PD) deficiency?

Sulfonamide

which group of antibiotics would require the patient to use suncreen and wear a hat to avoid the sun between 10:00 am and 4:00 pm?

Sulfonamides

which condition occurs when the normal flora are disturbed during antibiotic therapy?

Superinfection Antibiotic therapy can destroy the normal flora of the body, which typically inhibit the overgrowth of fungi and yeast. when the normal flora are decreased, these organisms can overgrow and cause infections. organ toxicity, hypersensitivity and rebound toxicity are not a disturbance in the normal flora associated with antibiotic therapy

What is the principal indication for sulfamethoxazole-trimethoprim (SMZ-TMP)?

Urinary tract infection

Which drug is contraindicated for a patient who is receiving erthromycin therapy?

Warfarin taking warfarin with erythromycin therapy may result in decreased warfarin metabolism and excretion, thereby leading to an increased risk of bleeding or hemorrhage.

which condition may the patient have when reporting flushing, itching, hives, anxiety and throat tongue swelling after taking an antibiotic?

an allergic anaphylactic reaction

prophylactic

antibiotic treatment is administered before the actual onset of an infection. surgery places a patient at a major risk for infection. Therefore antibiotic treatment given before surgery is a prophylactic treatment against infection.

Extended spectrum penicillins

are used to treat many health care associated infection, including pneumonia.

Which intervention would the nurse perform to ensure safety for a patient who has been prescribed clindamycin and is also asking vecuronium?

assess the patients respiratory rate

which intervenrtion is important for the nurse to perform for a female patient who has been prescribed amoxicillin?

assess whether the patient is on oral contraceptives

superinfection

can occur when antibiotic completely eliminate the normal bacterial flora.

which antibiootic is used for prophylaxis against infections in surgical patients?

cefazolin

A patient with pain and urinary tract develops fever, chills, and sore on the tongue. In the chart, the nurse finds an allergy to sulfonamide. Which drug does the nurse suspect is responsible for patients reaction?

celecoxib: COX-2 selective nonsteroidal antiinflammatory drug that helps in the treatment of acute pain. this drug contains sulfonamide and should be avoided in patinets with sulfonamide allergy

Which antibiotic can be used against several anaerobic organisms?

clindamycin

normal bacterial flors

consists of certain bacteria and fungi that are needed to maintain normal function in various organs.

which condition would the nurse suspects when a patient taking intravenous vancomycin reports frequent ringing. in the ear?

early vestibular damage Frequent ringing in the ear or tinnitus is an adverse effect of vancomycin.

Which action will the nurse implement when administering colistimethate sodium via inhalation?

ensure that emergency equipment is near the patient.

which drug does the nurse anticipate the health care provider will order for a patient diagnosed with legionnaires disease

erythromycin

which intervention would be included when planning care for a patient receiving a sulfonamide antibiotic?

force fluid to at least 2000 mL/day

which parameter would the nurse check before administering neomycin to a patient?

glomerular filtration rate(GFR) neomycin causes nephrotoxicity as and adverse effect therefore checking GFR determines drug concentration

which time range is the elimination half-life of amoxicillin?

half-life: 1 to 1.5 hours Duration action: 6 to 8 hours peak effect: 1 to 2 hours after administration

Which assessment will the nurse perform for a patient who is prescribed amikacin and is also taking loop diuretics?

hearing ability

which adverse drug effect would the nurse need to monitor for a patient with a tobramycin serum drug concentration greater than 2 mc/ml?

hearing impairment

which nursing assessment is most important for a patient who has been prescribed cefazolin sodium?

history, including allergies Antibiotic allergy is one of the most common allergies. these allergies also have the potential to cause severe anaphylaxias and death

Which interaction is caused by administering divalent minerals such as a calcium supplement within an hour of a quinolone such as levofloxacin?

impaired levofloxacin absorption Levofloxacin is a quinolone antibiotic. Calcium supplements interfere with levofloxacin absorption and reduce oral absorption of levofloxacin. Therefore the nurse instructs the patient to take calcium supplements at least 1 hour before or after taking levofloxacin to prevent this interaction

Which change will the nurse anticipate from the health care provider for a patient who is receiving vancomycin and has a serum drug concentration of 8 mcg/ml before the second dose is administered?

increase the dose of vancomycin this indicates that the dose of the drug is less than that which is requires to achieve therapeutic effects.

Penicillin

inhibits transpeptidases and activates autolysins. this disrupts the synthesis of the cell wall and promotes active destruction of the cell wall. these combined actions result in cell lysis and death. penicillin irreversibly inactivated a key enzyme in bacterial cell wall synthesis. but does not bind irreversibly to the cell wall. penicillin does not interrupt bacterial DNA or RNA processes to destroy bacteria.

which statement describes the nurses primary intervention for a patient prescribed suflamethoxazole/trimethoprim (SMZ-TMP)?

instruct the patient to increase fluid intake

Clavulanic acid

is a beta lactamase inhibitor. Administered concurrently, it augments the therapeutic effect of antibiotics like ampicillin. when ampicillin is administered by mouth, concurrent administration of calcium citrate can diminish its absorption. Acetaminophen and carbamazepine do not affect the pharmacokinetics of ampicillin.

Ceftriaxone

is administered in meningeal infection

Amoxicillin

is used as a dental prophylaxis for bacterial endocarditis.

Serum level of the antibiotic is too high

it causes a toxic reaction. gram positive and gram negative baterial infections do not cause superinfection

which mechanism of action describes how penicillin destroys bacteria?

it interferes with cell wall synthesis

Which antibiotic is used in patient who have infections of the eyes, ears or skin and for suppressing bowel flora before bowel surgery?

neomycin is an antibiotic commonly used for bacterial decontamination of the gastrointestinal tract before any surgical procedure and can be administered orally, topically and rectally.

Which nursing action suitable for a patient scheduled for an appendectomy who has a new prescription for neomycin?

oral administration of neomycin before the surgery

Which drug allergy may indicate the need for change of a new prescription for cefuroxime?

penicillin V potassium Cefuroxime is cephalosporin antibiotic that has a cross-interaction with penicillin antibiotics. Patietn who developed allergic reaction with penicillin may develop an allergic reaction to cephalosporin as well.

Which medication may sometimes be overlooked when considering penicillin allergies in patients?

piperacillin/ tazobactam (zosyn)

what type of antibiotic treatment is the patient likely receiving when administered intravenous ceftriaxone before an open cholecystomy ?

prophylactic

Which parameter is most important to assess before administering vancomycin to a patient?

renal function

which parameter will the nurse assess in the patient receiving vancomycin to ensure safe administration of the drug?

renal function

which parameter would the nurse assess for a patient receiving amikacin after a computed tomography (CT)scan?

serum creatinie

which medication will the nurse expect the health care provider to prescribe for a patient who has tuberculosis-associated plague?

streptomycin

Which response is indicated when the nurse learns a patient taking sulfadiazine has glucose-6-phosphate dehydrogenase(G6PD)

the nurse contacts the primary heath care provide before administration of the drug. Sulfadiazine belongs to the class of sulfonamides. the administration of sulfonamides to a patient with G6PD deficiency may results in hemolysis (destruction of red blood cells)

Which statement describes what the nurse would interpret from a patient on cefotetan therapy who reports stomach cramps, vomiting, diaphoresis, itching, headaches and who has hypotension on assessment?

the patient had taken ethanol (alcohol)in addition to the cefotetan. Cefotetan is a second-generation cephalosporin antibiotic. Combining ethanol (alcohol) and cefotetan causes drug-drug interaction.

which action can cause reduction in the therapeutic effect of doxycycline?

the patient took the medication with a glass of milk. Doxycycline is a tetracycline antibiotic. The absorption of the medciation may be reduced if it binds with calcium, magnesium or iron.

Sulfonamide therapy

the primary indication is urinary tract infection because these drugs achieve high concentrations in the kidney. The combination of these drugs allows for synergistic antibacterial effect. Furthermore, sulfonamides are indicated in treatment of infection with Escherichia coli, Klebsiella, proteus vulgaris and proteus mirabilis, staphylococcus aureus, pneumcystis jirovecii

which antibiotic will the nurse expects to administer to this patient as empiric therapy for a serious intra-abdominal infection?

ticarcillin-calvulanic acid: has one of the broadest antimicrobial spectra of all penicillins.

which reason explains why fluid intake should be increased up to 3000 ml per day for a patient taking sulfamethoxazole/ trimethoprim (SMZ-TMP)

to prevent drug -related crystalluria

Which inhalational medication would the nurse expect the primary health care provider to prescribe for a patient with cystic fibrosis who has developed a pulmonary infection?

tobramycin is an aminoglycoside drug that can be administered trough the inhalation route for the treatment of pulmonary infection caused by cystic fibrosis.

Empiric

treamtent is given after the onset of an infection but before the causative organism has been identified.

which statement describes how superinfection occur?

when the antibiotic eliminates the normal flora.