102 4
The patient is ordered daily divided doses of gentamycin. The patient received an intravenous dose of gentamycin at 4:00 PM. When should the nurse obtain the peak level?
4:30
What is the total time of treatment for tuberculosis (TB) multidrug therapy?
6-9 months
Isoniazid is metabolized by which organ?
Liver
How are most antibiotic medications eliminated from the body?
Through urine
Which patient should receive prophylatic antibiotic therapy?
A patient who is scheduled for a hysterectomy
A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug, which statement will the nurse include?
"Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin."
A nurse is doing discharge teaching with a patient receiving isoniazid and rifampin for a TB diagnosis, and the patient asks why two medications have to be taken. How does the nurse respond to this patient?
"Combinations decrease resistance and treatment time."
A patient being treated for TB asks to have a medication change to cycloserine because a family member read about the drug online. How should the nurse respond?
"Cycloserine is not as effective and can be more toxic."
A patient is prescribed an antibiotic to treat a urinary tract infection. Which statement by the patient indicates a need for further teaching?
"I can stop the medication as soon as the symptoms have disappeared"
A patient on IV vancomycin is tired of the long infusion times and would like to have his medication administered by IV push. What education should the nurse provide regarding this request?
"IV push is contradicted with vancomycin because fast administration can have a toxic effect known as Red Man Syndrome."
A hospitalized patient is prescribed multiple antibiotics for an infection. The patient asks why she is taking so many different types of antibiotics. What is the best response for the nurse to give?
"Multi-antibiotic therapy helps delay the development of microorganism resistance."
What response does the nurse give after the patient receiving multidrug therapy for TB asks about the length of time for treatment?
"Multidrug therapy is split into two phases, about 9 months total."
A student nurse is assisting a registered nurse with the admission of Ms. Houghton, and questions the registered nurse regarding the health care provider's order for pyridoxine. How should the registered nurse respond?
"Pyridoxine is necessary to prevent peripheral neuropathy."
A patient states she is feeling better after completing half of her antibiotic therapy with no complications. What education should the nurse provide?
"The prescription should be taken until completed even if you are feeling better."
A 30-year-old female patient is prescribed amoxicillin. Which education should the nurse provide?
"Use an additional form of birth control while taking this medication."
The nurse is preparing home instructions for a patient who has been diagnosed with a vaginal candidiasis infection. Which instruction should the nurse include when teaching the patient about taking antifungal medications?
"You must abstain from sexual intercourse until the treatment is finished and the infection is resolved."
A nurse is completing the admission assessment for a patient being treated with active tuberculosis. The patient states that he lives with his wife and son. Which patient teaching statement is appropriate?
"Your wife and son will need to have a purified protein delivery (PPD) test and may require prophylactic treatment."
At which time does the nurse tell the patient to take isoniazid in regard to food?
1 hour before or 2 hours after eating
What is the half life for isoniazid?
1-4 hours
The nurse is administering acyclovir to a patient with normal renal function. How long will it take for half the drug to be absorbed?
2-3 hours
The nurse is preparing to administer PO acyclovir to a patient. What is the half-life of the medication, assuming the patient has normal renal function?
2.5-3 hours
Which patient should receive prophylactic tubercular therapy?
A child whose sister has been recently diagnosed with active TB.
Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole (Bactrim) for a period of 6 months?
A female patient with recurring acute urinary tract infections
Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection?
A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain
A patient who has been prescribed acyclovir comes to the clinic complaining of dizziness when changing positions. What is the nurse's best action?
Advise the patient to change positions slowly
A dialysis patient is prescribed amoxicillin. When should the nurse administer the medication?
After dialysis
When teaching a patient about taking ketoconazole, what should the nurse tell the patient not to consume?
Alcohol
How is the frequency of antibiotic dosing altered if a patient has renal impairment?
Antibiotic dosing is less frequent
A patient receiving isoniazid is discussing a beach trip that is planned later in the month. What teaching does the nurse need to do with the patient prior to discharge?
Apply sunscreen
A 50-year old patient with a history of asthma and consuming 1-2 alcoholic drinks a day is being started on isoniazid therapy for active TB. What education regarding isoniazid therapy should the nurse include when discharging the patient?
Avoid drinking alcohol
Which statement about the BCG vaccine does the nurse identify as true?
BCG vaccine can be used to treat carcinoma of the bladder
When should a culture and sensitivity test be collected?
Before antibiotics are initiated
Amphotericin B treats fungal infections through which mechanism of action?
Binds to the fungal cell membrane and creates channels that increase cell permeability
Which instruction or warning would a nurse teach a patient who is taking rifampin?
Body fluids will turn orange
How do bacteriostatic antibiotics, which only inhibit bacterial growth, contribute to the elimination of infection?
They work in conjunction with the body's natural defense mechanisms
When taking zidovudine, the patient should have which lab value especially monitored?
Complete blood count
What should patients avoid within 3 hours of taking tetracycline?
Consuming dairy products
A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. What should the nurse do?
Contact the health care provider for a different antibiotic
The nurse is reviewing a patient's home medication list. The nurse notes that the provider has prescribed amphotericin B. Which home medication would have potential for interaction?
Digoxin
A patient has a follow-up appointment and is required to bring in a sputum specimen. The patient states, "I coughed this sputum up last night and saved it." What does the nurse need to do with the specimen?
Discard the specimen.
Which hygiene practice is a priority in teaching a patient with TB?
Discarding tissues and napkins that contain sputum.
When teaching a patient about antifungal medications, which teaching point should the nurse include?
Discontinuing the drug abruptly can cause a relapse
The nurse is reviewing provider orders for a newly admitted patient. Which lab value would alert the nurse that administration of an antifungal would be contraindicated?
Elevated liver enzyme values
Where is zidovudine completely absorbed?
GI tract
A patient is prescribed doxycycline (vibramycin). If the patient complains of gastric irritation, what should the nurse do?
Give the patient food, such as crackers or toast, with the medication
What laboratory test has significant impact on the health care providers choice of antibiotic regimen?
Gram stain
Which examination should the patient receive while receiving streptomycin for TB?
Hearing screen
Which statements are true regarding the peak concentration times of oral and IM isoniazid?
IM and oral peak concentration time are the same.
What should a patient do to assist with drug excretion while taking antibiotics?
Increase fluid intake
How does isoniazid act on tubercle bacteria?
Inhibits cell wall synthesis
How does acyclovir work against the herpes virus?
Interferes with the virus DNA synthesis and disrupts the replication process
Which drug was the first oral drug preparation effective in treating tubercle bacillus?
Isoniazid (INH)
What additional effect can occur if food is taken with an antibiotic to prevent GI upset?
It can delay absorption of the antibiotic
The nurse teaches Anna about amoxicillin. Which statement made by Anna indicates that further teaching is required?
It is okay for me to stop taking my medicine as soon as I feel better
Why is a continuous antibiotic infusion effective in the treatment of a severe infection?
It provides constant drug concentration and time exposure
What benefit is seen with antibiotics that have longer half-lives?
Less frequent dosing
The nurse is administering zidovudine to a patient by mouth. Through which organ is this medication metabolized?
Liver
Which disease in the patient's health history is a contraindication to prophylactic treatment for tuberculosis?
Liver disease
A patient who sustained second- and third-degree burns has been prescribed mafenide. Which statement about mafenide does the nurse identify as true?
Mafenide is painful upon application
What priority teaching needs to done with a patient who states he has not taken isoniazid treatment for the past two days because he has been feeling better?
Medication compliance
A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication?
Metronidazole
What does the abbreviation MEC stand for in discussions of antibiotics?
Minimum Effective Concentration
Which tetracycline may be administered with meals?
Minocycline
What teaching point is important for the nurse to share with Mr. Franklin?
Mr. Franklin should use condoms or practice sexual abstinence to avoid spreading herpes.
A patient has been prescribed ciprofloxacin for treatment of a urinary tract infection with Escherichia coli. Before administering the drug, it is most important for the nurse to assess the patient for a history of what?
Myasthenia gravis
Before administering gentamycin, it is important for the nurse to assess the patient for a history of what?
Myasthenia gravis
Which drug does the nurse identify as a urinary tract antiseptic?
Nitrofurantoin
The patient is being discharged with continued ciprofloxacin therapy. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops?
Pain in the heel of the foot
The nurse is treating a patient who has been prescribed amphotericin B while in the hospital. Which electrolyte does the nurse need to assess while caring for this patient?
Potassium
A perscriber states that a patient will need to receive penicillin intravenously. The nurse anticipates administering which drug?
Potassium penicillin G
Acyclovir is in which class of antivirals?
Purine nucleosides
Which information should the nurse include when teaching a patient about rifampin therapy?
Rifampin may be administered intravenously
Why is it important to record a baseline neurologic assessment before administering antibiotics?
Some antibiotics have the potential for adverse CNS effects
A nurse would encourage a patient to participate in which kind of testing to evaluate the effectiveness of an antitubercular drug regimen?
Sputum testing
Which statement about super infections does the nurse identify as true?
Super infection is defined as a new infection that appears
Fluoroquinolones should be discontinued immediately if what happens?
Tendon pain or inflammation develops
A pregnant patient in her third trimester says that she would like to take tetracycline as an acne treatment because it has always worked for her in the past. What teaching should the nurse provide for this patient?
Tetracycline is contraindicated for pregnant women.
A patient with TB is not understanding why pyridoxine is being prescribed in addition to the isoniazid. How should the nurse respond?
The production of vitamin B6 is blocked, so pyridoxine can prevent peripheral neuropathy.
Effectiveness of an antibiotic is dependent on which factor?
The length of time that it remains at the bacterial cell-binding site
Why are microorganisms that cause health care-associated infections so difficult to treat?
The micro organisms have been exposed to strong antibiotics in the past, which has made them more drug resistant and virulent
The nurse is caring for a patient receiving intravenous gentaminicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of the gentamycin therapy?
Tinnitus
Which are therapeutic uses of zidovudine? Select all that apply.
Treating infection with HIV, Preventing mother to infant HIV transmission
The nurse is reviewing laboratory values from a patient who has been prescribed gentamincin. To prevent otoxicity, it is most important for the nurse to monitor which value(s)?
Trough drug levels of gentamicin
When treating a patient with antiviral medication, the nurse must monitor for signs of adverse effects. Which assessments should the nurse obtain to monitor whether the patient is having an adverse reaction to the medication? Select all that apply.
Urinary output, serum creatinine, blood urea nitrogen
Before administering erthromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine of the patient is also prescribed which drug?
Verapamil (Calan)
A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment the nurse expects to find what?
Widespread skin lesions
A patient has been prescribed oral ciprofloxacin (Cipro) for a skin infection. When administering the medication, it is most important for the nurse to do what?
Withhold antacids and milk products for 6 hours before or 2 hours afterward
A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin?
alcohol
Which information should the nurse include when teaching a patient about isoniazid (INH) therapy?
an adverse effect of isoniazid therapy is peripheral neuroopathy, which can be reversed with pyridoxine
Which statement about allergic reactions to penicillin does the nurse identify as true?
anaphylactic reactions occur more frequently with penicillins than with any other drug
Which statement about amoxicillin is true?
it is bactericidal
What effect does a bactericidal antibiotic have on a pathogen?
kills the pathogen
Which laboratory tests would the nurse draw prior to initiating antitubercular medications? Select all that apply.
liver enzymes, BUN, serum creatinine
It is most important for the nurse to avoid administering oral ciprofloxacin to this patient with which food?
milk
A patient is prescribed vancomycin orally for antibiotic associated pseudo membranous colitis. The nurse will monitor the patient for What?
ototoxicity
A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what?
skin rash, hives, or itching
If a patient on amoxicillin reports a rash, what is the first step the nurse should take?
stop administering the medication
