Pharmacology Unit 9 Ch. 19

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

A client is questioning the nurse about a superinfection that developed while receiving fluoroquinolone therapy. Which response by the nurse would be most appropriate?

"The drug disrupts your normal bacteria so it allows other organisms to grow."

Which of the following should a nurse recognize as an aminoglycoside? Select all that apply. -Amikacin (Amikin) -Amoxicillin (Amoxil) -Kanamycin (Kantrex) -Azithromycin (Zithromax) -Vancomycin (Vancocin)

-Amikacin (Amikin) -Kanamycin (Kantrex)

A nursing student is engaged in researching information about fluoroquinolones. When examining the information, the student would most likely find that this class of drugs is effective in treating which type of infection? Select all that apply. -Gram-positive infections -Fungal infections -Viral infections -Parasitic infections -Gram-negative infections

-Gram-positive infections -Gram-negative infections

After teaching a group of nursing students about fluoroquinolones, the instructor determines that the teaching was successful when the group chooses which drug as an example? Select all that apply. -Levofloxacin -Ciprofloxacin -Cephalexin -Amoxicillin -Spectinomycin

-Levofloxacin -Ciprofloxacin

A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions? (Select all that apply.) -Profuse sweating -Dizziness -Nausea -Headache -Constipation

-Nausea -Headache -Dizziness

The nurse is evaluating the medical records of several clients and note some are receiving both fluoroquinolone and corticosteroid therapy. The nurse concludes which client is at the greatest risk for tendonitis?

72-year-old male

A client with a severe infection has an order for IV gentamicin and IV penicillin. How will the nurse administer these medications?

Administer the gentamicin IV and wait 1 hour and administer the penicillin.

A client developed a nosocomial (hospital-acquired), gram-negative infection when hospitalized. What is considered the antibiotic of choice for this type of infection?

Aminoglycosides

A client is to receive gentamicin for treatment of an infection. Which of the following would be most important for the nurse to assess to establish a baseline?

Auditory function

You are writing a plan of care for a patient taking an oral fluoroquinolone. What would be an appropriate intervention to include in this plan?

Avoid concomitant use of nephrotoxic drugs.

A client develops pseudomembranous colitis secondary to fluoroquinolone therapy. The nurse anticipates the bowel culture will grow which organism?

C. difficile

The nurse instructs the client who is taking oral ciprofloxacin to avoid which food while taking this medication?

Cheese

Prior to administration of fluoroquinolones, which laboratory test should be obtained?

Culture and sensitivity

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

When fluoroquinolones are administered intravenously, the nurse would check the needle site and area around the needle site for extravasation at which frequency?

Every hour

A client develops a severe case of pseudomembranous colitis secondary to fluoroquinolone therapy. The fluoroquinolone is stopped immediately and intravenous fluids and protein supplementation are started. The nurse would also expect to administer which new medication?

Fidaxomicin

A client is prescribed ciprofloxacin for an acute sinus infection. The nurse knows that this anti-infective medication belongs to which drug category?

Fluoroquinolones

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?

Fluoroquinolones

Which of the following classes of antibiotics is a direct inhibitor of DNA synthesis in bacteria?

Fluoroquinolones

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

Gentamicin

Your client is currently taking aminoglycosides. You know that this type of medication is used in all of the following microorganisms, EXCEPT:

Gram-positive cocci.

A 75-year-old male client is diagnosed with an infection. He is currently being treated for type 2 diabetes, hypertension, benign prostatic hypertrophy, and chronic congestive heart failure. If the health care provider orders a fluoroquinolone to treat the infection, the nurse understands that what adverse effects can occur in this client?

Hypoglycemia and hyperglycemia

A male client is concerned that he cannot afford to have his wife's community-acquired pneumonia (CAP) treated in the hospital. He has limited health insurance, and the cost of intravenous antibiotic therapy is prohibitive. According to the American College of Chest Physicians' position statement, where will the client's wife be treated?

In the home using oral drugs

When considering known adverse reactions to gentamicin therapy, the nurse should focus assessment of what body structure?

Inner ears

The pharmacology instructor is discussing ways to decrease adverse effects on clients taking aminoglycosides. Which would the instructor include?

Keeping the client well hydrated

Which of the following medications is contraindicated in children?

Levofloxacin

The nurse recognizes that what drug classification increases the risk of ototoxicity and nephrotoxicity when prescribed with gentamicin?

Loop diuretics

A male client is NPO as a consequence of a cerebrovascular accident sustained 3 years ago. His care is managed at home by his wife, and he receives all medications via gastrostomy tube. The health care provider orders a fluoroquinolone for the client to treat an infection. The nurse would instruct the client's wife to administer the medication in what way?

On an empty stomach

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

Oral

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?

Oral (PO)

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?

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?

Photosensitivity

Aminoglycosides fight infection by interfering with what process within the causative bacterium?

Protein synthesis

The nurse is caring for a child weighing 30 kg. The healthcare provider orders gentamicin 100 mg IV three times per day. The recommended dosage range is 6 to 7.5 mg/kg/day. What action should the nurse take?

Question the prescriber about the dosage of the medication.

A client in the critical care unit is receiving aminoglycosides for an infectious process. What does the nurse need to monitor?

Renal function tests

A client scheduled to undergo major abdominal surgery has been prescribed preoperative neomycin. Neomycin is used preoperatively for what reason?

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.

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 chronic renal failure

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

The use of ciprofloxacin is contraindicated in pregnancy.

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?

antacids

An older adult client is prescribed intravenous ciprofloxacin for the treatment of a urinary tract infection. What nursing assessment should the nurse prioritize to identify potential adverse effects?

blood glucose monitoring

A client has endocarditis and is taking gentamicin. The nurse will be sure to monitor the client's:

creatinine clearance.

After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication?

gram-negative infections

The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which?

increase fluid intake.

A 66-year-old woman with a history of recurrent urinary tract infections has been admitted to the hospital with a diagnosis of pyelonephritis. The client began treatment 36 hours ago with intravenous gentamicin and is being monitored closely. The nurse is aware that the therapeutic effect of the client's drug regimen is primarily a result of:

interference with bacterial reproduction.

A nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which would the instructor include?

interfering with DNA synthesis in the bacterial cell

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

Gentamicin therapy is indicated in the treatment of what medical diagnosis?

osteomyelitis

A client has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause which?

ototoxicity or nephrotoxicity.

What is the treatment goal for a preoperative prescription for neomycin?

suppression of intestinal bacteria

A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to

take the vitamins at least 2 hours before or after taking ciprofloxacin.

A nurse is caring for a 52-year-old man with pyelonephritis. The health care provider has prescribed gentamicin. Which pair of symptoms would alert the nurse to a serious adverse reaction?

tinnitus and decreased urinary output

A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment?

urine output and BUN and creatinine levels