Pharmacology Chapter 9: Antibiotics

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?

"Are you pregnant?"

The nurse is assessing a young female client who is prescribed an aminoglycoside to treat a gram-negative bacterial infection. Which question will the nurse ask the client before providing a dose of the medication?

"Are you pregnant?"

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."

After teaching the client about taking the prescribed sulfonamide therapy, the nurse determines that the client needs additional teaching after they make which comment?

"I can take the drug at different times of the day each day."

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 should drink a full 8-oz glass of water when I take the medicine."

The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media and prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse?

"If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."

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?

"Make sure to avoid drinking any alcohol for the next three days."

Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply. -Ulcerative colitis -Urinary tract infection -Acute otitis media -Upper respiratory tract infection -Osteomyelitis

-Ulcerative colitis -Urinary tract infections -Acute otitis media

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?

225 mg

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

The nurse administers cefuroxime to a client at least 1 hour before meals, as prescribed; however, the client experiences GI upset. Which action would be most appropriate for the nurse to do?

Administer the drug with foods

A nurse is caring for a 39-year-old client who is taking INH, rifampin, and pyrazinamide. The client reports that her urine is red. What is the most likely cause of this discoloration?

Adverse effect of rifampin

AA bacterium that depends on oxygen in order to survive is called:

Aerobic

A client diagnosed with infective endocarditis would be most effectively treated with which medication?

Ampicillin

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?

Ampicillin will reduce the effectiveness of birth control pills

Antibiotic drugs are commonly used in the pediatric population. Why would the tetracyclines be contraindicated in children younger than 8 years of age?

Because of the drugs effects on teeth and bone

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?

Chlamydia

An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?

Confirm the client's allergy status

Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order?

Culture and sensitivity

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

A nurse is caring for a client daignosed with a serious gram-negative infection prescribed amikacin. Which action should the nurse prioritize while caring for this client?

Do renal tests daily

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

Erythromycin

A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?

Erythromycin

T/F: Aminoglycosides are an example of antibiotics that are classified as bacteriostatic

False

T/F: Fluoroquinolones are used to treat susceptible strains of gram-positive bacteria

False

T/F: Infections of the genitourinary tract are commonly the result of gram-positive bacteria

False

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

The sulfonamides treat infections by inhibiting synthesis of which?

Folic acid

Which does not use oxygen to survive?

Gangrene

Compared with penicillins, cephalosporins more appropriate for treating infection by what type of microorganism?

Gram-negative bacteria

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

The health care professional has recommended sulfonamide therapy for a client who is currently taking oral anticoagulants. What are the possible effects of combining sulfonamide therapy with oral anticoagulants?

Increased action of the anticoagulant

A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?

Inflammation of the tongue and mouth

A client has returned to the clinic for follow-up of an infection which is being treated with an aminoglycoside and reports ringing in the ears and dizziness. When developing this client's plan of care, which nursing diagnosis would be the priority?

Injury risk

What is the rationale for not administering tetracycline to children under the age of 8 years?

It will interfere with enamel development

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

Jaundice

What is a contraindication to use of a fluoroquinolone?

Lactation

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

Liver function

A patient with a throat infection has been recommended penicillin therapy by the primary health care provider. Before administering the first dose of penicillin to the patient, which interventions should the nurse perform as part of the pre-administration assessment?

Obtain a patient's general health history

A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client?

Orally, on an empty stomach

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?

Penicillin

What event triggers the development of a superinfection?

Proliferation of antibiotic-resistant microorganisms

A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client?

Renal damage

Prior to and following a transurethral prostatic resection (TUPR), a 73-year-old man has been scheduled to receive a total of five intravenous doses of cefazolin. Which of the following nursing diagnoses should the nurse associate with this antibiotic therapy?

Risk for Infection related to overgrowth of nonsusceptible organisms

A middle-aged client is to receive tetracycline for treatment of H. pylori infection, as well as continue with digoxin for a history of heart disease. The nurse will be prepared to monitor the client for which potential condition?

Risk for digoxin toxicity

A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions?

Risk of toxicity

When antibiotics are given in combination so that their combined effects are greater than if they were given individually, they are considered to be:

Syngergistic

Tetracyclines should not be used in children younger than 8 years of age because of their effects on:

Teeth and bones

Which is true of gram-negative bacteria

The cell wall is decolorized by alcohol

How will a client's diagnosis of liver cirrhosis affect the potential use of appropriate ampicillin therapy to treat an infected pressure ulcer?

The client can safely be treated with ampicillin

The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?

The client has developed a superinfection

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?

These are normal side effects, but if they increase in severity or frequency, you need to contract the office again

T/F: A Gram's stain is used to identify gram-positive bacteria by retaining a stain within its cell wall

True

T/F: Cephalosporins can be classified as either bactericidal or bacteriostatic depending on which specific drug and dose are used

True

T/F: When patients are allergic to penicillin, erythromycin has proven to be an effective alternative

True

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?

Urinary tract infections

The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client?

Use a type of barrier birth control while you are taking this antibiotic

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?

Vomiting and diarrhea

Drugs that destroy bacteria are known as which type of drug?

bactericidal

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

can cause allergic reactions in clients who are allergic to penicillins

The nurse is reviewing recent laboratory values for an older client prior to administration of tetracycline. Which finding would lead the nurse to hold the dose?

creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

Penicillins are most effective when used to treat what type of microorganisms?

gram-positive bacteria

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

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?

numbness and tingling in his feet

A client being treated with an oral penicillin should be encouraged to administer the medication on which schedule to best achieve a therapeutic effect? Select all that apply. -At bedtime -With meals -At regular intervals -Around the clock -Upon rising in the am

-At regular intervals -Around the clock

Which drug-specific nursing conclusion(s) may be used in the administration of a penicillin to a client? Select all that apply. -Impaired gastrointestinal (GI) comfort -Impaired skin integrity -Increased risk for respiratory dysfunction -Impaired renal function -Risk of allergic response

-Impaired gastrointestinal (GI) comfort -Impaired skin integrity -Increased risk for respiratory dysfunction -Impaired renal function -Risk of allergic response

A nurse is assessing the laboratory test results of a client receiving sulfasalazine therapy for ulcerative colitis. Which findings would be a priority? Select all that apply. -Pancytopenia -Leukopenia -Thrombocytopenia -Aplastic anemia -Iron deficiency anemia

-Leukopenia -Thrombocytopenia -Aplastic anemia

After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was successful when the students choose which medication as an example of a sulfonamide antibiotic? Select all that apply. -Amoxicillin -Ciprofloxacin -Sulfamethoxazole/trimethoprim -Clarithromycin -Silver sulfadiazine

-Sulfamethoxazole/trimethoprim -Silver sulfadiazine

A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?

Assessing for renal insufficiency

When a person is diagnosed with tuberculosis, the nurse prepares the family members to be treated prophylactically with which drug?

Isoniazid