Antibiotics 2

A client with mild diarrhea is diagnosed with a Clostridium difficile infection. Which medication is the first-line medication used to treat this condition? Rifaximin Fidaxomicin Vancomycin Metronidazole

Metronidazole Metronidazole is the first-line treatment prescribed to clients with a Clostridium difficile infection. Rifaximin isused to treat traveler's diarrhea caused by Escherichia coli. Fidaxomicin is reserved for clients who are at risk for the relapse of or have recurrent Clostridium difficile infections. Vancomycin is preferred for serious Clostridium difficile infections.

Which medication would the nurse identify as a potential cause for the formation of abnormally small eyes in the newborn if used during pregnancy? Estrogens Nitrofurantoin Methotrexate Valproic acid

Nitrofurantoin Nitrofurantoin, an antimicrobial medication, causes formation of abnormally small eyes in the newborn. Sex hormone supplements, such as estrogens, may cause congenital defects of female reproductive organs. Methotrexate can cause congenital abnormalities (central nervous system and limbs malformations) and fetal death. Valproic acid is highly teratogenic and causes neural tube defects, atrial septal defect, cleft palate, hypospadias, polydactyly, and craniosynostosis.

A client has a prescription for nitrofurantoin 50 mg orally every evening to manage recurrent urinary tract infections. Which instruction would the nurse give to the client? "Increase your intake of fluids." "Strain your urine for crystals and stones."" Stop taking the medication if your urinary output increases." "This may turn your urine green."

"Increase your intake of fluids." To prevent crystal formation, the client should have sufficient intake to produce 1000 to 1500 mL of urine daily while taking this medication. Straining urine is not indicated when the client is taking a urinary anti- infective. If fluids are encouraged, the client's output should increase. Nitrofurantoin turns urine dark yellow to brown, not green.

Which conditions can precipitate delirium? Select all that apply. One, some, or all responses may be correct. A. Infection B. Dementia C. Dehydration D. Urine retention E. Medications

A,C,D,E Infections, especially urinary tract infections in older clients, may cause delirium because they may become systemic. A memory aid for recalling the causes of delirium is DELIRIUMS: Drugs, Emotional factors, Low arterial oxygen level, Infections, Retention of urine or feces, Ictal or postictal state, Undernutrition, Metabolic conditions, and Subdural hematoma. Dehydration and fluid and electrolyte imbalances may lead to delirium because of the decrease in fluid and change in concentrations of electrolytes in the brain. Retention of urine may progress to a urinary tract infection that becomes systemic, which can cause delirium. Dementia is a chronic, irreversible cause of mental status changes. It must be differentiated from delirium, which is treatable.

A sulfonamide preparation is prescribed for a child with a urinary tract infection. Which nursing responsibility is a priority when administering this medication? Weighing the child daily Giving the medication with milk Taking the child's temperature frequently Administering the medication at the prescribed times

Administering the medication at the prescribed times For the desired blood level to be maintained, the medication must be administered in the exact amount at the times directed. If the blood level of the medication falls, the microorganisms have an opportunity to build resistance to the medication. Weighing is important with medications that affect fluid balance, such as diuretics. Sulfa medications should be given on an empty stomach to promote absorption. Monitoring the temperature is important with antipyretic medications.

Which category of isolation would the nurse implement for a client who is positive for Clostridium difficile? Airborne precautions Droplet precautions Contact precautions Protective environment

Contact precautions Contact precautions should be used for direct client or environmental contact with blood or body fluids from an infected client. This includes colonization of infection with multidrug-resistant organisms (MDROs) such as methicillin-resistant Staphylococcus aureus (MRSA), stool infected with Clostridium difficile, draining wounds where secretions are not contained, or scabies. Airborne precautions are used for infected droplets smaller than 5 mcg, such as measles, chickenpox (varicella), or pulmonary tuberculosis (TB). Droplet precautions are used for droplets larger than 5 mcg and when within 3 feet (0.9 m) of the client, such as streptococcal pharyngitis, mumps, and influenza. Protective environment focuses on clients with a compromised immune system to protect them from incoming pathogens.

A client recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary health care provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests would the nurse expect the primary health care provider to prescribe to confirm this diagnosis? Cystoscopy and bilirubin level Specific gravity and pH of the urine Urinalysis with a urine culture and sensitivity Creatinine clearance and albumin/globulin (A/G) ratio

Urinalysis with a urine culture and sensitivity The client's manifestations may indicate a urinary tract infection; a culture of the urine will identify the microorganism, and sensitivity will identify the most appropriate antibiotic. A cystoscopy is too invasive as a screening procedure; altered bilirubin results indicate liver or biliary problems, not urinary signs and symptoms. Creatinine clearance reflects renal function; A/G ratio reflects liver function. Although an increased urine specific gravity may indicate red blood cells, white blood cells, or casts in the urine, which are associated with urinary tract infection, it will not identify the causative organism.

Trimethoprim/sulfamethoxazole is prescribed for a child with a urinary tract infection. Which statement by the parent indicates the nurse's instructions about administration have been understood? "Mealtime is a good time to give the medication." "I'll make sure to give each pill with 6 to 8 oz of fluid." "It must be taken with orange juice to ensure acidity of urine." "The medication has to be taken every 4 hours to maintain a blood level."

"I'll make sure to give each pill with 6 to 8 oz of fluid." This is a sulfa medication; water must be encouraged to prevent urine crystallization in the kidneys. This medication does not have to be given with meals; it is administered every 12 hours. Orange juice causes an alkaline urine; water is the best fluid to be administered with this medication. This medication maintains the blood level for 8 to 12 hours; it is an intermediate-acting medication.

A client currently taking medication for bacterial vaginosis complains of an unpleasant metallic taste, nausea, and vomiting. Which medication would be responsible for this condition? Tinidazole Miconazole Clotrimazole Metronidazole

Metronidazole Metronidazole is used to treat bacterial vaginosis. Common side effects include an unpleasant metallic taste in the mouth, furry tongue, central nervous system reactions, and urinary tract disturbances. Tinidazole is used to treat trichomoniasis. Miconazole and clotrimazole are used to treat candidiasis.

A child is prescribed tetracycline. The nurse understands which possible medication-related reaction is associated with this medication? Kernicterus Gray syndrome Reye syndrome Staining of teeth

Staining of teeth Tetracycline causes staining or discoloration of developing teeth in children. Sulfonamides may causekernicterus in neonates. Chloramphenicol may cause Gray syndrome in infants. Aspirin may cause Reye syndrome in pediatric clients with a history of chickenpox or influenza.