Pharm Ch 18
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
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
A client is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame?
60 minutes
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
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 1 hour before meals, as prescribed; however, the client experiences GI upset. Which action would be most appropriate for the nurse to do?
Administer the drug with food.
A client receiving penicillin therapy reports mouth irritation and a sore throat to the nurse. Inspection reveals a red, swollen tongue with ulcerations. The nurse suspects a fungal superinfection and prioritizes which nursing diagnosis as most appropriate for this client?
Altered Oral Mucous Membranes
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.
A client being treated for cellulitis with a cephalosporin asks what the essential difference is between generations of this medication. The nurse should respond to the client's question based on what fact?
Each successive generation is more effective against gram-negative microorganisms.
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
As a class, penicillins usually are more effective in infections caused by which type of bacteria?
Gram-positive
A client develops a mild skin irritation while receiving penicillin therapy. Which products or actions would the nurse advise the client to avoid? Select all that apply.
Harsh soaps Perfumed lotions Rubbing the irritating area Wearing rough or irritating clothing
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.
When discussing cephalosporins with the nursing class, the pharmacology instructor explains that this classification of drug is primarily excreted through which organ?
Kidney
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 client with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which intervention is most important for the nurse to perform when caring for this client?
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
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
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
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 caring for a patient who has a serious infection. The patient is being treated with combination therapy of a cefazolin and an aminoglycoside. The nurse will be sure to monitor which of the following?
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.
Cefazolin, a cephalosporin, is used for which of these conditions? (Choose all that apply.)
Streptococcus pneumoniae infection Otitis media Perioperative prophylaxis Septicemia
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.
A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?
UTIs
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 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
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 young adult client who has no significant prior health history has been prescribed antibiotics for the first time. What nursing conclusion would be most appropriate for this client?
deficient knowledge regarding drug therapy
The client is receiving keflex 1000 mg/day. The nurse properly identifies this drug as a:
first-generation cephalosporin.
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 nurse is assessing a client who is receiving vancomycin intravenously. While the drug is being administered, the client reports a throbbing sensation in their neck and back and paresthesias. The client's blood pressure has dropped and their neck and back are erythematous. The nurse suspects which adverse finding?
red man syndrome
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.
A 13-year-old male patient has been prescribed oral cefuroxime. The patient's parents should ensure that he takes the medication
with food.