Chapter 15: Drugs Affecting
When preparing a teaching plan for a group of students about the ways organisms develop resistance to anti-infective therapy, what would the instructor be least likely to include in the discussion?
The organism produces some chemical to mimic the drug.
Which client would be at risk of developing an infection? Select all that apply.
a client with an impaired immune system a client experiencing diarrhea chronically an elderly client who has one chronic disease
A 70-year-old client has been prescribed an antimicrobial drug for the treatment of a urinary tract infection (UTI). What teaching point should the nurse prioritize when providing client education?
"Make sure that you take all the pills that you're prescribed, even if your infection gets better."
A client asks a nurse why the health care provider has prescribed two anti-infective agents. Which response by the nurse would be most appropriate?
"Your infection, like many infections, is caused by more than one organism."
The hospital nurse is caring for a diverse group of clients and is reviewing each client's medication regimen. Which client is most likely to benefit from combination therapy?
A client being treated for acquired immunodeficiency syndrome (AIDS)
You are working as a nurse educator in the hospital setting. Part of your responsibility includes developing a plan to prevent antibiotic resistance. What is the most important part of your plan?
An education campaign that focuses on handwashing between patients
The pathophysiology class is learning how microorganisms develop resistance to anti-infective drugs. What is one way the students would learn that microorganisms develop resistance to anti-infective drugs?
By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
What would contribute to drug resistance?
Antibiotic prescription for viral illness
Which nursing interventions should be included in the plan of care for a client receiving antimicrobial medications? Select all that apply.
Assess and document vital signs. Assist with instruction on pulmonary hygiene. Review laboratory values, including white blood cell counts. Maintain adequate fluid intake.
A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead?
Development of drug resistance
After teaching a group of students about adverse reactions to anti-infective agents, the instructor determines that the students need additional teaching when they identify what as a common adverse effect?
Cardiac toxicity
The nursing instructor is discussing the signs and symptoms of infection. Which of the following is a local sign of infection?
Edema
The nurse is providing health education to a client with an infection who lives in the community. What characteristic of the client's anti-infective regimen will best prevent the development of resistant strains of microbes?
Ensuring that the duration of drug use is appropriate
A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?
Refer the client to the health care provider because the client may be experiencing resistance.
Which of the following is the most important nursing action to help prevent antimicrobial resistance in health care settings?
Good hand-washing between each patient contact
Major defense mechanisms of the human body include all of the following EXCEPT:
Increased platelet cells.
A client is to receive penicillin. The nurse understands that this drug achieves its effect by which action?
Interfering with the pathogen cell wall
What is critical to helping prevent development of resistant strains of microbes?
Maintain the optimum duration of the antimicrobial agent.
The female client has been taking a fluoroquinolone and calls the health care provider's office to report that she is experiencing redness and is excoriated in her groin area. What is the nurse's best response?
Notify the health care provider.
It is the duty of all health care providers to prevent antibiotic resistance. As a nurse, how can you play an active role in preventing antibiotic resistance? (Select all that apply.)
Obtain culture specimens prior to administration of antibiotic therapy. Use proper isolation procedures. Report culture results to the health care provider.
An older adult client has been brought to the emergency department by her daughter, who states that the client may have a urinary tract infection. What principle should guide the care team's plan of treatment?
Older adults' signs and symptoms of infection may differ from those of younger people
An 82-year-old woman with influenza and pneumonia has been admitted to the hospital for IV antibiotic therapy. Which type of antibiotic would rely the least on the client's defense mechanisms?
Penicillin
After teaching a group of students about resistance, the instructor determines that the students need additional teaching when they identify what as a way that microorganisms develop resistance?
Production of a chemical to act as an antagonist
Bactericidal compounds fight infection and destroy microorganisms by inhibiting what?
Protein synthesis
The nurse is caring for an older adult client who is being treated for community-acquired pneumonia. Over the past 12 hours, the client has had three episodes of diarrhea despite having no known history of gastrointestinal disease. What is the nurse's best action?
Report this sign of a possible superinfection to the provider.
The nurse is providing care for an older adult who has a urinary tract infection. What aspect of this client's current health status should the nurse focus on when ensuring safe and effective antibiotic therapy?
The client has a history of cirrhosis.
Successful treatment with bacteriostatic antibiotics depends upon what factor? Select all that apply.
The ability of the host's immune system to eliminate the inhibited bacteria. Providing an adequate duration of appropriate drug therapy.
The nurse administers a drug to treat Chlamydia trachomatis. The nurse is aware that this drug has no effect on any other bacteria. How should the nurse describe this characteristic of the drug?
The drug has a narrow spectrum
A nurse has questioned why a client's health care provider has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?
The use of broad-spectrum antibiotics can create a risk for a superinfection.
Like many other classes of drugs, anti-infective drugs can have a variety of adverse effects. What is the most common, potentially serious, adverse effect of antimicrobial drugs?
Toxic effects on the kidney
Which are examples of bactericidal control used in the health care environment? Select all that apply.
Use of cleaning agents by the nurse or other care providers Maintaining a sterile environment when inserting a urinary catheter
A nurse is asked to explain the difference between community-acquired infections and nosocomial infections. What response best describes the difference?
Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired.
A client comes to the clinic reporting mouth sores that appear consistent with an oral yeast infection. The nurse should question the client about recent use of:
antibiotics.
A client is febrile and is suspected of having a respiratory infection. A sputum culture has been collected and the results of sensitivity testing are expected within 48 hours. The nurse should anticipate that the client may:
be immediately prescribed a broad-spectrum antibiotic.
Administration of what type of antibiotic by the nurse would be most likely to cause a superinfection?
broad spectrum
The nurse administering an anti-infective agent recognizes that the drug will destroy some human cells as well as pathogens because of the absence of:
selective toxicity.
Successful treatment with bacteriostatic antibiotics depends upon:
the ability of the host's immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy.
A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that:
the microorganism causing the infection is likely known.
What is a major factor that influences whether an individual will acquire an infection?
the person's ability to defend against the would-be invaders