Chapter 15: Drugs Affecting Inflammation and Infection-PHARM

Which client would be at risk of developing an infection? Select all that apply. a client experiencing diarrhea chronically a client with an impaired immune system an elderly client who has one chronic disease a client who performs daily hygiene care a client who takes nutritional supplements

a client with an impaired immune system a client experiencing diarrhea chronically an elderly client who has one chronic disease Explanation: Many factors impair the host defense mechanisms and predispose a person to infection by disease-producing microorganisms. These include breaks in the skin and mucous membranes, impaired blood supply, neutropenia and other blood disorders, malnutrition, poor personal hygiene, suppression of normal bacterial flora by antimicrobial drugs, diabetes mellitus and other chronic diseases, and advanced age. A client who has chronic diarrhea can experience malnutrition. A client who performs daily care and a client who takes nutritional supplements are not at risk for infection.

A nurse is caring for a client who is hospitalized for pneumonia. The nurse reviews the electronic health record and evaluates that the microbiology data does not support the use of the broad spectrum antibiotic. Which statement is the nurse's best response to the provider about the results? "The charge nurse prefers that you call her about the antibiotic coverage for the client." "I think you need to review the microbiology report for the client." "I have reviewed the client's record and the client does not want the antibiotic." "The microbiology data is identifying another antibiotic appropriate for the client."

"The microbiology data is identifying another antibiotic appropriate for the client." Explanation: Laboratory tests used to definitively identify causative organisms and to determine susceptibility to antibiotics usually require 48 to 72 hours, so the prescriber usually initiates treatment with an antimicrobial drug that is likely to be effective. The nurse should communicate with the prescriber about the change so that a correction can be made as soon as possible. Telling the prescriber to review the microbiology report is incorrect. The basis of prescribing the antibiotic should be on the identifying bacteria's culture and sensitivity. Referring the prescriber to the charge nurse is inappropriate as it is the nurse's responsibility to discuss with the prescriber the client's care.

The nurse admits a client with septicemia (infection in the bloodstream). The client denies any allergies and the provider has ordered cefuroxime based on blood culture and sensitivity testing. The client states, "I'd prefer vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response? "You can't believe anything you read on the Internet because most of it is just someone's opinion and not fact." "I appreciate your concern but you can certainly rest assured that the health care provider ordered the right medication for your needs." "There are some resistant infections that require vancomycin so you are right to prefer a stronger antibiotic." "Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work."

"Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work." Explanation: The client is right in saying that vancomycin is effective against drug-resistant bacteria but needs help to understand that he or she does not have a resistant infection, as indicated by the culture and sensitivity, and that use of such a powerful drug when it is not needed increases risk of developing a vancomycin-resistant infection. It is never right to tell a client "not to worry" because they have every right to participate in his or her own care and should not be patronized. Although some information on the Internet may not be accurate, it would be incorrect to say it is all just someone's opinion and not fact, especially given that the client's information is accurate.

Which client is most at risk for an opportunistic infection? A 45-year-old client with contact dermatitis A 14-year-old client with HIV infection A 33-year-old client with hepatitis A A 25-year-old client with asthma

A 14-year-old client with HIV infection Explanation: The client most at risk for an opportunistic infection is the one with the HIV infection because the immune system is compromised with this disease.

For what client would a broad-spectrum antibiotic be most appropriate? A client who has symptoms of infection but whose culture and sensitivity results are not yet available A client with a respiratory infection who is 84 years old A client whose urinary tract infection has been attributed to Escherichia coli A client who has an oral temperature of 100.2° F (37.9° C) but no other signs or symptoms of infection

A client who has symptoms of infection but whose culture and sensitivity results are not yet available Explanation: Broad-spectrum antibiotics are often used to treat infections while awaiting the results of culture and sensitivity testing. The presence of a fever with no other signs of infection would not be an indication for the use of broad-spectrum antibiotics. Narrow-spectrum antibiotics are generally preferred when the causative microorganism of an infection is known. Advanced age is not an indication for broad-spectrum antibiotic use.

What would contribute to drug resistance? High dosage to eradicate the organism Around-the-clock scheduling Prescribed duration of therapy Antibiotic prescription for viral illness

Antibiotic prescription for viral illness Explanation: The use of antibiotic prescription for viral illnesses or infections is a contributing factor to the development of resistance. A high enough drug dosage and long enough duration of therapy helps to ensure complete eradication of even slightly resistant organisms. Around-the-clock dosage scheduling eliminates peaks and valleys in drug concentration and helps to maintain a constant therapeutic level to prevent the emergence of resistant microbes.

The nurse is preparing to administer a new anti-infective to a client. The nurse should prioritize what assessment? Cranial nerve function Assessment for toxic epidermal necrolysis (TEN) Bowel pattern Assessment for allergic reaction

Assessment for allergic reaction Explanation: Anaphylaxis is an acute, systemic allergic response to a substance that can be fatal if medical intervention does not occur almost immediately because the airway closes due to tissue edema making it impossible to breathe. TEN is a serious, but rare, drug reaction. The potential seriousness of anaphylaxis means that it should be prioritized over bowel function and cranial nerve assessment.

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? Hypersensitivity Neurotoxicity Kidney damage Cardiac toxicity

Cardiac toxicity Explanation: Cardiac toxicity is not typically associated with anti-infective therapy. Adverse effects commonly associated with anti-infective therapy are direct toxic effects on the kidney, gastrointestinal tract, and nervous system along with hypersensitivity and superinfections.

A female client is treated with antibiotics for bacterial pneumonia. When obtaining a drug history, the nurse finds that the client ceased her medication regimen when she no longer experienced symptoms during the first round of antibiotics. The nurse is responsible for the client's education plan. In order to effectively treat the pneumonia, what must the client do? Continue the antibiotics for 1 week after cessation of symptoms. Complete a full course of antibiotics as prescribed. Take the antibiotics at breakfast, lunch, and supper. Take the antibiotics every 3 hours during the day.

Complete a full course of antibiotics as prescribed. Explanation: Client education related to antibiotic therapy should stress the importance of completing a full course of antibiotics as prescribed.

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? Increased rate of elimination of the drug Development of drug resistance Increased chances of serious adverse events Decreased absorption of the drug

Development of drug resistance Explanation: When there is irregular or indiscriminate use of antibiotics, certain pathogens may mutate or build a tolerance to the drug. The antibiotic then becomes ineffective against that organism. Irregular use does not affect the absorption or elimination of the drug or increase chances of serious adverse events of the antibiotic.

A client with an inflammatory disease has been prescribed indomethacin. The nurse is aware of the risk for drug-induced nephrotoxicity and should prioritize what intervention? Educating the client about sodium limitation Monitoring closely for hematuria Encouraging the client to increase fluid intake Administering the medication with meals whenever possible

Encouraging the client to increase fluid intake Explanation: Adequate hydration is important whenever a client is receiving a potentially nephrotoxic drug. Limiting sodium intake and administering drugs with food do not mitigate this risk. Kidney damage most often results in oliguria and changes to urine and blood chemistry, not hematuria

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? Proactively addressing the possibility of adverse effects Ensuring that the duration of drug use is appropriate Performing culture and sensitivity testing after the completion of treatment Maximizing the frequency of drug ingestion

Ensuring that the duration of drug use is appropriate Explanation: Exposure of pathogens to an antimicrobial agent without cellular death leads to the development of resistance so it is important to limit the use of these agents to treat pathogens with a known sensitivity to the drug being used. The duration of drug use is critical to ensure that microbes are completely eliminated and not given the chance to grow and develop resistant strains. Adverse effects must be addressed, but this is not directly related to the development of resistance. Dosing frequency must be determined with the goal of enhancing the therapeutic action, but excessive frequency can cause problems with the client's adherence. Follow-up testing is not a major component of preventing 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 Reporting culture and sensitivity results in a timely manner Using aseptic technique for all nursing procedures Documenting improvement or worsening of symptoms of infection

Good hand-washing between each patient contact Explanation: Antimicrobial resistance is a major concern worldwide because hospitals are most likely to harbor resistant bacteria, it is important that nurses use aseptic technique for all procedures; obtain culture specimens appropriately; communicate culture and sensitivity results in a timely manner; adhere to isolation procedures; document improvement or worsening of symptoms of infection; and most importantly, practice good hand-washing between each patient contact. Washing hands between patients will help prevent the spread of resistant bacteria.

The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug? It will directly cause the death of pathogenic cells. It is effective against many different organisms. It is effective in interfering with cell reproduction. It is selective in its action on organisms.

It will directly cause the death of pathogenic cells. Explanation: Bactericidal refers to a highly aggressive drug that causes cell death. An anti-infective with a narrow spectrum of activity is selective in its action so that it is effective against only a few microorganisms with a very specific metabolic pathway or enzyme. Bacteriostatic refers to a drug's effectiveness in interfering with a cell's ability to reproduce or divide. Broad-spectrum activity refers to effectiveness against a wide variety of pathogens.

Which intervention is necessary to perform prior to initiating antibiotic therapy? Increase fluid intake. Monitor for adverse effects. Obtain a specimen for culture and sensitivity. Administer an antidiarrheal to prevent GI upset.

Obtain a specimen for culture and sensitivity. Explanation: Collect specimens (e.g., sputum, urine) for culture and Gram stain before giving the first dose of an antibiotic. For best results, specimens must be collected accurately and taken directly to the laboratory.

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first? Evaluating the bactericidal effects Obtaining sensitivity testing Using combination therapy Checking client allergies

Obtaining sensitivity testing Explanation: Performing sensitivity testing on cultured microbes is important to evaluate the bacteria and determine which drugs are capable of controlling the particular organism. Once the sensitivity testing is completed, then the decision for the drug can be made. Combination therapy is used when appropriate after culture and when sensitivity testing has been completed. Checking client allergies also would be done after sensitivity testing but before administering the drug. The bactericidal effects of a drug may or may not play a role in the selection of the drug.

A nurse is caring for a child weighing 30 kg. The health care provider orders gentamicin (Garamycin) tid for the client. The recommended dosage range is 6 to 7.5 mg/kg/day. Why is it important to give a dosage within this recommended range? (Select all that apply.) So the child gets too much medication Give a safe dose for this size child. To eradicate the bacteria Because this microorganism only affects this size child Prevent overdose in the child.

Prevent overdose in the child. Give a safe dose for this size child. To eradicate the bacteria Explanation: Drug dosage is important in preventing the development of resistance. Doses should be high enough and the duration of drug therapy should be long enough to eradicate even slightly resistant microorganisms. The recommended dosage for a specific anti-infective agent takes this issue into account. The recommended dose is not set because a microorganism only affects a certain size child or to make sure the child gets too much medication.

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? Assess the client for a new onset of drug hypersensitivity. Refer the client to the health care provider because the client may be experiencing resistance. Assess the client for additional signs of superinfection. Educate the client about the phenomenon of drug tolerance.

Refer the client to the health care provider because the client may be experiencing resistance. Explanation: Resistance refers to the organism's ability to adapt over time to an antibiotic and produce cells that are no longer affected by a particular drug. Destruction of the normal flora by anti-infectives commonly leads to superinfection, an infection that occurs when opportunistic pathogens that were kept in check by the normal bacteria have the opportunity to invade the tissues. Hypersensitivity or allergic reactions result from antibody formation. Tolerance exists when a client needs a higher dose to achieve the same therapeutic effect as in the past; with anti-infectives, however, resistance is more likely.

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? Obtain a stool sample for ova and parasite testing. Advocate for a change in the client's medication regimen. Report this sign of a possible superinfection to the provider. Obtain a stool sample for culture and sensitivity testing.

Report this sign of a possible superinfection to the provider. Explanation: This client has most likely been receiving antibiotics and the rapid onset of diarrhea is suggestive of a superinfection. The care provider should be informed and then any necessary laboratory testing will be ordered. Interventions will likely be necessary but this may or may not include a change in the client's medication regimen.

A female client calls the pediatrician's office because her child reports a sore throat. The nurse anticipates the pediatrician will take what action? Order an antibiotic. Request a throat culture. Request a list of drug allergies. Order an antitussive.

Request a throat culture. Explanation: For sore throat, a throat culture for streptococcal organisms should be performed and the results obtained before an antibiotic is prescribed.

The nursing instructor and her students are discussing ways to prevent the spread of infection. Which of the following measures should the instructor identify as the most important? Maintaining reverse isolation protocols Maintaining access to an infectious disease specialist Giving antimicrobials as prescribed Rigorously and consistently applying recommended precautions

Rigorously and consistently applying recommended precautions Explanation: Rigorous and consistent use of recommended precautions helps to protect health care providers and patients regardless of the type of infection. These basic precautions include using appropriate personal protective gear and treating all patient fluids as infectious. The other options describe measures that may be important for specific patients or infections.

The nurse is administering an anti-infective medication that is known to lack total selective toxicity. What consequence should the nurse anticipate? The microbe's enzyme production will be slowed Some healthy cells will be damaged. All pathogens in the body will be destroyed. Bacterial DNA will mutate

Some healthy cells will be damaged. Explanation: When a drug does not display selective toxicity, healthy cells are damaged because the drug does not specifically target only the pathogen. Anti-infectives work by a variety of different means so one drug is not likely to kill every type of pathogen in the body. Selective toxicity does not impact enzyme production or cause mutation.

The nurse is assessing a client who has recently been given the first dose of a new anti-infective. What finding should lead the nurse to suspect that the client is experiencing a hypersensitivity reaction? The client recently had an episode of diarrhea. The client is experiencing vertigo. The client has a facial and trunk rash. The client's blood pressure is 141/88 mm Hg.

The client has a facial and trunk rash. Explanation: Rash suggests a hypersensitivity reaction. Vertigo may suggest a neurotoxic adverse effect. Diarrhea may occur over time as a result of gastrointestinal adverse effects. A blood pressure that is slightly elevated is not suggestive of hypersensitivity.

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 is bacteriostatic The drug has a narrow spectrum The drug has prophylactic qualities The drugs is bactericidal

The drug has a narrow spectrum Explanation: Without knowing the name of the antibiotic and how it works to treat N. gonorrhoeae, the only thing that can be said is that it is a narrow-spectrum anti-infective because it only treats one specific organism. Broad-spectrum anti-infectives treat multiple organisms. The name of the drug and how it works would need to be known to determine whether it is bacteriocidal or bacteriostatic.

When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include? The drug is highly aggressive in killing the pathogen. The drug is selective in its action on organisms. The drug is effective against many different organisms. The drug is effective in interfering with the cell's reproduction.

The drug is selective in its action on organisms. Explanation: An anti-infective with a narrow spectrum of activity is selective in its action; thus, it is effective against only a few microorganisms with a very specific metabolic pathway or enzyme. Broad-spectrum activity refers to effectiveness against a wide variety of pathogens. Bactericidal refers to a highly aggressive drug that causes cell death. Bacteriostatic refers to a drug's effectiveness in interfering with a cell's ability to reproduce or divide.

A male client is diagnosed with a drug-resistant infection in his wound. What should the home care nurse teach the client and his family? To use gloves when handling drainage from the wound To avoid social contact while the infection is treated To use bleach when washing all laundry To avoid using the same bathroom until the infection abates

To use gloves when handling drainage from the wound Explanation: General infection-control practices include frequent and thorough hand hygiene, use of gloves when indicated, and appropriate handling and disposal of body substances (e.g., blood, urine, feces, sputum, vomitus, wound drainage).

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? Constipation Pain Toxic effects on the kidney Skin rash

Toxic effects on the kidney Explanation: The most commonly encountered adverse effects associated with the use of anti-infective agents are direct toxic effects on the kidney, gastrointestinal (GI) tract, and nervous system. Pain, constipation, and hypopnea are not common adverse effects of antimicrobial drugs.

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. Only drug-resistant strains of staphylococci, Pseudomonas, and Proteus are categorized as nosocomial infections. Usually, nosocomial infections are less severe and easier to treat since community-acquired infections often result from drug-resistant microorganisms. There is no epidemiological difference between the infection types; they are simply categorized as community-acquired or nosocomial.

Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired. Explanation: Infections are often categorized as community-acquired or nosocomial. Because the microbial environments differ, the two types of infections often have different causes and require different antimicrobial treatment. Generally, community-acquired infections are less severe and easier to treat, although antibiotic-resistant strains are increasing (e.g., methicillin-resistant Staphylococcus aureus [MRSA]). Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. Drug-resistant strains of staphylococci, Pseudomonas, and Proteus are common causes of nosocomial infections.

A nurse is asked to explain the difference between community-acquired infections and nosocomial infections. What response best describes the difference? Usually, nosocomial infections are less severe and easier to treat since community-acquired infections often result from drug-resistant microorganisms. Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired. There is no epidemiological difference between the infection types; they are simply categorized as community-acquired or nosocomial. Only drug-resistant strains of staphylococci, Pseudomonas, and Proteus are categorized as nosocomial infections.

Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired. Explanation: Infections are often categorized as community-acquired or nosocomial. Because the microbial environments differ, the two types of infections often have different causes and require different antimicrobial treatment. Generally, community-acquired infections are less severe and easier to treat, although antibiotic-resistant strains are increasing (e.g., methicillin-resistant Staphylococcus aureus [MRSA]). Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. Drug-resistant strains of staphylococci, Pseudomonas, and Proteus are common causes of nosocomial infections.

You are speaking to a group of clients in a public meeting. They ask you to explain the difference between community-acquired infections and nosocomial infections. Your best response is: Only drug-resistant strains of staphylococci, Pseudomonas, and Proteus are categorized as nosocomial infections. Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. There is no difference between the infection types, they are simply categorized as community-acquired or nosocomial. Usually, nosocomial infections are less severe and easier to treat. Community-acquired infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.

Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. Explanation: Infections are often categorized as community-acquired or nosocomial. Because the microbial environments differ, the two types of infections often have different causes and require different antimicrobial treatment. As a general rule, community-acquired infections are less severe and easier to treat, although antibiotic-resistant strains are increasing (eg, methicillin-resistant Staphylococcus aureus [MRSA]). Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. Drug-resistant strains of staphylococci, Pseudomonas, and Proteus are common causes of nosocomial infections.

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? Surveillance of staff performing invasive procedures Providing a flyer to all staff members about the importance of preventing antibiotic resistance An education campaign that focuses on handwashing between patients Conducting a poster presentation in the cafeteria of the types of isolation used at your facility

an education campaign that focuses on handwashing between patients Explanation: Handwashing is one of the most effective ways to prevent antibiotic resistance, by preventing diseases from being spread from one person to another.

A drug that does not actually cause the death of a cell but does interfere with its ability to reproduce is said to be: bactericidal. broad spectrum. drug resistant. bacteriostatic.

bacteriostatic. Explanation: A drug that is bacteriostatic does not kill the cell but interferes with its ability to reproduce. Bactericidal drugs cause the death of the cell. Drug resistance is the ability of a pathogen to adapt and no longer be susceptible to an anti-infective. Bacteriostatic activity can be found in both broad- and narrow-spectrum anti-infectives.

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: need to provide a follow-up sputum culture before medications can be prescribed. receive supportive care until an antibiotic can be prescribed in 48 hours. be immediately prescribed a broad-spectrum antibiotic. be treated with antiviral medication on a short-term basis.

be immediately prescribed a broad-spectrum antibiotic. Explanation: Broad-spectrum antibiotics are often prescribed pending sensitivity testing. There is no need to completely withhold medications until results are acquired. Antiviral medications are not used for this short-term purpose. Follow-up testing may or may not be needed.

Administration of what type of antibiotic by the nurse would be most likely to cause a superinfection? bactericidal narrow spectrum broad spectrum bacteriostatic

broad spectrum Explanation: One offshoot of the use of anti-infectives, especially broad-spectrum anti-infectives, is destruction of the normal flora, allowing opportunistic pathogens to invade tissue and cause a superinfection. Narrow-spectrum anti-infectives are less likely to kill normal flora, although it is not impossible. A drug may be bactericidal, meaning it kills the pathogen; or bacteriostatic, meaning it prevents reproduction of the pathogen, but this is not related to superinfections.

A client is receiving an aminoglycoside antibiotic for an infection. The nurse would monitor the client closely for: visual changes. hallucinations. lethargy. hearing loss.

hearing loss. Explanation: Aminoglycosides collect in the eighth cranial nerve and can cause hearing loss, dizziness, and vertigo. Lethargy and hallucinations may be associated with other anti-infective agents. Visual changes such as blindness are associated with chloroquine use.

What intervention is necessary for the nurse to perform prior to initiating prescribed antibiotic therapy? increasing the client's fluid intake administer an antidiarrheal to prevent gastrointestinal (GI) upset educating the client about adverse effects obtaining a specimen for culture and sensitivity

obtaining a specimen for culture and sensitivity Explanation: It is good practice to collect specimens (e.g., sputum, urine) for culture and Gram's stain before giving the first dose an antibiotic. Fluid intake and medication education may take place after the therapy is initiated, while antidiarrheal medication is administered if the client demonstrates signs/symptoms of GI distress.

A client is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of: synergism. prophylaxis. curative treatment. chemotherapy.

prophylaxis. Explanation: In a situation where an infection is likely to occur, antibiotics can be used as a means of prophylaxis to prevent an infection before it occurs. Synergism is using two antibiotics together to improve their effectiveness. Chemotherapy is the use of drugs to kill cells. Curative treatment involves treating an actual infection to promote a cure.

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: antigens. virulence. resistance. selective toxicity.

selective toxicity. Explanation: Although anti-infective agents target foreign organisms infecting the body of a human host, they do not possess selective toxicity, which is the ability to affect certain proteins or enzyme systems used only by the infecting organism but not by human cells. Virulence would apply to the destructive power of the infection, not the drug. Resistance is the pathogen's ability to no longer respond to specific anti-infectives. Antigens are proteins bound to the cell that help the body identify a cell as belonging (or not) in the body, and are not the cause of human cell destruction.

People taking antimicrobial drugs should be instructed to report any problem that could indicate adverse drug effects, lack of therapeutic response, or emergence of another infection. One such problem is: headache. constipation. skin rash. muscle soreness.

skin rash. Explanation: Clients should be instructed to report nausea, vomiting, diarrhea, skin rash, recurrence of symptoms for which the antimicrobial drug was prescribed, or signs of new infection (e.g., fever, cough, sore mouth, drainage). These problems may indicate adverse effects of the drug, lack of therapeutic response to the drug, or another infection.

Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is: infections that tend to recur and involve simple organisms. the host's ability to defend itself against the would-be invaders. continuous antimicrobial treatment of infections. the number of effective drugs available for serious or antibiotic-resistant infections.

the host's ability to defend itself against the would-be invaders. Explanation: The human body and the environment contain many microorganisms, most of which do not cause disease and live in a state of balance with the human host. When the balance is upset and infection occurs, characteristics of the infecting microorganism and the adequacy of host defense mechanisms are major factors in the severity of the infection and the person's ability to recover. Conditions that impair defense mechanisms increase the incidence and severity of infections and impede recovery. In addition, use of antimicrobial drugs may lead to serious infections caused by drug-resistant microorganisms.

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. the care team wished to reduce the client's risk of adverse effects. the client likely has compromised immune function. broad spectrum antibiotics were likely administered without success.

the microorganism causing the infection is likely known. Explanation: Narrow spectrum antibiotics are appropriate when the identity of the microorganism is known or strongly suspected. This is unrelated to the client's immune function. Broad spectrum drugs are not necessarily trialed before using narrow spectrum drugs. The risk of adverse effects is not the determining factor.

What is a major factor that influences whether an individual will acquire an infection? implementation of continuous antimicrobial treatment of the infection the infection's tendency to recur and involve simple organisms the person's ability to defend against the would-be invaders the number of effective drugs available to an antibiotic-resistant infections

the person's ability to defend against the would-be invaders Explanation: The human body and the environment contain many microorganisms, most of which do not cause disease and live in a state of balance with the human host. When the balance is upset and infection occurs, characteristics of the infecting microorganism and the adequacy of host defense mechanisms are major factors in the severity of the infection and the person's ability to recover. Conditions that impair defense mechanisms increase the incidence and severity of infections and impede recovery. In addition, use of antimicrobial drugs may lead to serious infections caused by drug-resistant microorganisms.

An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with clindamycin. an antistaphylococcic penicillin. vancomycin. ciprofloxacin.

vancomycin. Explanation: Vancomycin is the drug of choice to manage infections caused by MRSA. MRSA is resistant to all of the antistaphylococcic penicillins, as well as to ciprofloxacin and clindamycin.