Chp 7-Anti-Infectives That disrupt the cell wall

The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?

"Make sure to avoid drinking any alcohol for the next three days."

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

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

A client with gram-negative bacteria allergic to penicillin

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

The client calls the clinic to report the he is experiencing a throbbing headache and his face is flushed. The client received cefotetan as an IV antibiotic prior to a minor surgical procedure the day before, and returned home that same day. What has this client consumed that has caused this reaction?

Alcohol

A client diagnosed with infective endocarditis would be most effectively treated with which medication?

Ampicillin

A nurse is preparing to give a client an initial dose of a penicillin preparation. What should the first action be for the nurse?

Ask the client if there is a history allergy to a penicillin.

Natural penicillins have been available since 1941 to treat infections. What problem has developed since 1941?

Drug-resistant strains of microorganisms have developed.

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.

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?

It inhibits cell wall synthesis.

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 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

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

Oxacillin

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 nursing instructor is teaching about a new emerging bacteria that has both natural and acquired resistance and that affects the severely ill, immunocompromised clients in intensive care, transplant, and some cancer treatment units. This is which?

VRE

A disulfiram-like reaction may occur if which substance is consumed within 72 hours after administration of certain cephalosporins?

alcohol

A client has just received a first dose of intravenous nafcillin when he immediately begins to have difficulty breathing and loses consciousness. The nurse takes the client's vital signs: blood pressure is 88/50 with a pulse oxygenation of 88%.What should the nurse suspect?

anaphylactic reaction

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 concentration of any drug in the body is referred to as which of the following?

blood level

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

A client who has been on long-term Geocillin therapy for repeated urinary tract infections (UTIs), reports severe abdominal cramping. The client also states that he has been having bloody diarrhea and rectal bleeding. What should the nurse suspect?

superinfection

Due to the close relationship cephalosporins have with penicillins, what percentage of clients who are allergic to penicillins are also allergic to cephalosporins? (Choose one)

10%

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

30 minutes

It is effective against gram-positive organisms

A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

What potential adverse reaction is most likely to develop during cefazolin therapy?

Gastrointestinal upset

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.

Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?

Penicillin

A 36-year-old client with a history of rheumatic fever is scheduled for dental surgery. The primary care provider orders this client to take penicillin for 3 days before and for 3 days after surgery. This is a case of which type of therapy?

Prophylaxis

A 64-year-old client is admitted to your unit with exacerbation of chronic heart failure and pneumonia and started on cefixime. On the third hospital day, you are assessing the client and note white patches in his mouth, and he is complaining of diarrhea. What would be the most likely reason for these symptoms?

The client has developed a superinfection because the antibiotic has destroyed the normal bacterial flora in his body.

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 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:

oral contraceptives.

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 nursing instructor is teaching students about the uses of cephalosporins. Teaching has been effective when students identify which diseases treated successfully with cephalosporins? Select all that apply.

respiratory infections otitis media bond/joint infections gastrointestinal tract infections

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