prepu chpt 7

A 4-year-old client being discharged from the hospital is ordered an oral-suspension cephalosporin. When the nurse instructs the mother to store the bottle in the refrigerator, the mother asks, "Why does that matter?" The nurse's best response would be which?

"Drugs that require refrigeration lose potency if kept at room temperature."

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."

A client has been diagnosed with a sinus infection and the client has been given a prescription for amoxicillin. What teaching point is most appropriate for this client?

"Take your medication every 8 hours, as it's been prescribed."

A postoperative client is ordered Keflex 250 mg every 6 hours for 5 days. How much Keflex will the client receive in a 24-hour period?

1 Gram

The nurse is giving instructions to a client who is being discharged home with a prescription for augmentin. The nurse informs the client that the best time to take this medication is:

1 hour before meals and 2 hours after a meal.

A client has been prescribed 200 mg of cefpodoxime every 12 hours. On hand are 25-milligram tablets. To meet the prescribed dose, the nurse administers ___________ tablets at each dosage

8

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

A cross-sensitivity reaction.

Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?

A defective cell wall

When learning about the different classes of cephalosporins, the nurse correctly identifies which of the following statements?

A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

The client calls the clinic to report the he is experiencing a throbbing headache and his face is flushed. The client received cefotetan as an IV antibiotic prior to a minor surgical procedure the day before, and returned home that same day. What has this client consumed that has caused this reaction?

Alcohol

Culture and sensitivity testing of a client's urine sample reveals a bacterium that is susceptible to cephalosporins. What medication would be most likely for the nurse to administer?

Cefaclor

A client has a history of a life-threatening anaphylactic reaction to penicillin G. Which medication should not be administered to this client?

Cefadroxil (Duricef)

A client is diagnosed with febrile neutropenia. Which medication is <b>most</b> effective in treating this client?

Cefepime hydrochloride (Maxipime)

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect?

Cell wall synthesis

A client with diabetes is ordered a cephalosporin to treat a recurring infection. The client is taking insulin and reports controlling the blood glucose level by monitoring it with urine stips and adjusting doses of insulin accordingly. What instructions should the nurse tell this client?

Cephalosporin may interfere with accurate test results.

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?

Drink a full glass of water when taking a dose of the drug

Natural penicillins have been available since 1941 to treat infections. What problem has developed since 1941?

Drug-resistant strains of microorganisms have developed.

Which of the following herbs has some evidence that supports its use to treat diarrhea caused by bacteria or intestinal parasites?

Goldenseal

The nurse understands that bacterial resistance can result when certain bacteria produce penicillinase. What does penicillinase do?

Inactivates penicillin

The pharmacology instructor is explaining combination drugs to the nursing class.The instructor tells the students that the combination of a beta-lactamase inhibitor and a penicillin produces what effect?

It extends the spectrum of antibacterial activity of the penicillin.

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.

Some combination antibacterial drugs consist of a penicillin and a beta-lactamase inhibitor. What is the primary purpose of a beta-lactamase inhibitor in one of these drugs?

It protects the penicillin.

An older adult is to receive a low dose of a cephalosporin for an infection. When realizing that this client has age-related diminished renal function, what intervention should the nurse implement?

Monitor 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?

Nausea

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the client reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity

Your client has been diagnosed with streptococcal pharyngitis. Which of the following would you anticipate being ordered?

Penicillin G

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the health care provider before administering the ordered medication?

Takes high-dose furosemide (Lasix) daily

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.

A 64-year-old client is admitted to your unit with exacerbation of chronic heart failure and pneumonia and started on cefixime. On the third hospital day, you are assessing the client and note white patches in his mouth, and he is complaining of diarrhea. What would be the most likely reason for these symptoms?

The client has developed a superinfection because the antibiotic has destroyed the normal bacterial flora in his body.

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 contact the office again.

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 nursing instructor is teaching about a new emerging bacteria that has both natural and acquired resistance and that affects the severely ill, immunocomprimised clients in intensive care, transplant, and some cancer treatment units. This is which?

VRE

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

ampicillin

A client has just received a first dose of intravenous nafcillin when he immediately begins to have difficulty breathing and loses consciousness. The nurse takes the client's vital signs: blood pressure is 88/50 with a pulse oxygenation of 88%.What should the nurse suspect?

anaphylactic reaction

A client receieving the first dose of IV ampicilllin asks the urse to evaluate a rash on the torso. What should be the nurse's initial response to the client's rash?

attempt to differentiate a hypersensitivity reaction from a nonallergic ampicillin rash

After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?

bactericidal

The concentration of any drug in the body is referred to as which of the following?

blood level

A 67-year-old client with a history of chronic illness is receiving penicillin therapy. The client's age and health history indicate an increased susceptibility to pseudomembranous colitis. The nurse would be alert for which finding?

bloody diarrhea rectal bleeding

Which drug is a first-generation cephalosporin used as a surgical prophylaxis?

cefazolin

A client is scheduled for a bowel resection. During the perioperative period, which type of medication should the nurse anticipate the client will be given?

cephalosporins

The client is receiving keflex 1000 mg/day. The nurse properly identifies this drug as a:

first-generation cephalosporin.

What potential adverse reaction is most likely to develop during cefazolin therapy?

gastrointestinal upset

A client is administered a third-generation cephalosporin. The broad-spectrum agents like cephalosporins are most effective in treating which type of microorganism?

gram negative

Cephalosporins might interfere with the accuracy of which test?

ketone urine test

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

methicillin-resistant Staphylococcus aureus (MRSA) infection

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.

The nursing instructor is teaching the students about different gastrointestinal adverse reactions to penicillin. What other reactions may occur with this medications administration?

pain at the injection site irritation at the vein phlebitis

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections?

pseudomembranous colitis

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.

A nurse monitors a client closely for anaphylactic reactions secondary to penicillin therapy. The nurse understands that this occurs more commonly after which route of administration?

parenteral

A male client who has undergone surgery of the urinary tract is administered cephalosporins to prevent infections. When assessing the client on the day after the surgery, the nurse notices that he has an elevated temperature. Which nursing intervention would be most appropriate in this case?

Inform the primary health care provider

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

A 36-year-old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

A client with a complex medical history is scheduled to begin with an IV cephalosporin. After the initiation of therapy, the nurse should monitor the client for which potential adverse effect of intravenous cephalosporin therapy?

nausea and vomiting abdominal pain diarrhea

Penicillin would NOT be indicated for which of the following clients?

A client with gram-negative bacteria allergic to penicillin

A 34-year-old female client is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The client reports gastrointestinal distress. The nurse will encourage the client to do which?

Take the drug with food.

Ampicillin-sulbactam is administered to a client with Staphylococcus aureus. What type of antiinfective is ampicillin-sulbactam?

penicillin-beta-lactamase inhibitor combination

Which reaction should a nurse assess for in a client who could develop a fungal superinfection in the oral cavity after being administered penicillin?

Inflamed mucous membranes

The nursing instructor is teaching about penicillins in pharmacology class. TThe instructor informs her students that there are different groups of penicillins. These include which groups?

natural penicillins penicillinase-resistant penicillins aminopenicillins extended-spectrum penicillins