Ch 18 Prep U

The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask?

"Has she ever received tetracycline?"

Your client receives IV vancomycin every 12 hours. You know that this infusion should run over:

1-2 hrs

A client has been started on augmentin 250 mg P.O. every 12 hr. It is supplied in 500-mg tablets. How much will the nurse give at each dose?

1/2 tab

Penicillins may trigger an anaphylactic reaction in some clients. Within what period following injection of a penicillin is anaphylaxis most likely to occur?

30 mins

A health care provider prescribes a client 3.375 g piperacillin sodium and tazobactam (Zosyn) every six hours. After reconstitution, the concentration of the drug is 2.25 g/50 mL. Which quantity of the reconstituted solution should the nurse administer to the client?

75 mL

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 nurse administers cefuroxime to a client at least one hour before meals, as prescribed. However, the client experiences a GI upset. Which is an appropriate nursing intervention in this case?

Administer the drug with food.

A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?

By administering the drug in separate IV bags

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

Unless hemodialysis is started within 48 hours, imipenem is contraindicated for clients with severe renal impairment. What laboratory measurement would indicate renal impairment?

Creatinine clearance

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?

Decrease the drug dose.

As a class, penicillins usually are more effective in infections caused by which type of bacteria?

Gram-positive

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.

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 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient?

Monitoring blood creatinine levels.

Penicillins are categorized into which of the following four groups? Select all that apply.

Natural penicillins Penicillinase-resistant penicillins Aminopenicillins Extended-spectrum penicillins

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

During ongoing assessment of a client receiving cephalexin (Keflex), the nurse should monitor the client for which of the following? Select all that apply.

Relief of symptoms Development of a rash Increase in appetite Change in appearance or amount of drainage Decrease in temperature

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.

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 nurse is administering cefazolin to a client. What adverse reactions should the nurse recognize as being the most problematic for this client? (Select all that apply.)

Vaginal yeast infection Facial edema

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

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 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 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

Cephalosporins are usually bacteriostatic. True or false?

false

You know that penicillins are more effective when used on what type of bacteria?

gram + bacteria

Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?

nephrotoxicity

An instructor is describing an antibiotic that is resistant to the enzyme penicillinase. What would the nurse identify as an example?

oxacillin

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

pain at the injection site irritation at the vein phlebitis

A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use?

penicillin

Cephalosporins are structurally and chemically related to which classes of antibiotics?

penicillins

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

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug

with a glass of water 1 hour before or 2 hours after a meal.