Chapter 18

The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent says they 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?

"Have they ever received tetracycline?"

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

1 to 2 hours.

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 tablet

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

Penicillin would NOT be indicated for which of the following clients?

A client with gram-negative bacteria allergic to penicillin

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.

Which of the following should be included in the nurse's pre-administration assessment prior to a client receiving a cephalosporin? Select all that apply.

Allergy history Medical history Medication history Current symptoms

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

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.

A male client is admitted to the unit for a total hip replacement. The surgeon orders a first-generation cephalosporin as a surgical prophylaxis because of what type of bacteria commonly associated with this type of procedure?

Gram-positive

Penicillins are more effective when used on infections caused by what organism?

Gram-positive bacteria

Penicillins and cephalosporins are used cautiously in neonates due to what factor?

Immature kidney function

The nurse is administering penicillin to a client who has strep throat. Which of the following statements accurately describe the action of penicillin?

It is effective against gram-positive organisms

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test?

Liver function

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.

A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?

Nausea

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

The nurse is observing a graduate nurse administering medications. The other nurse would intervene if the graduate nurse attempted to give what medication intravenously?

Penicillin G benzathine

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

Penicillins

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

Serum BUN and creatinine levels

A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions should a nurse perform when preparing penicillin in parenteral form?

Shake the vial well to distribute the drug evenly.

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.

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

methicillin-resistant Staphylococcus aureus (MRSA) infection

A nurse is conducting an in-service education program for a group of nurses. When describing the action of the various classes of penicillins, which class would the nurse identify as having the narrowest spectrum of activity?

natural 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

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the healthcare provider before administering the ordered medication?

takes high-dose furosemide daily