Pharm Ch. 8 tetracyclines, macrolides, lincosamides (prep u, vocab + quizletA)
The client has been diagnosed with a serious infection caused by gram-negative aerobic bacilli. The client has been prescribed IV gentamicin. What statement by the client should the nurse follow up *most* promptly?
"I feel like I'm having trouble hearing the last little while."
superinfection symptoms and interventions
-diarrhea -inspect stools for blood and mucus -increase fluid intake
MacrolidesPrecautions/Contraindications
-hypersensitivity -hepatic impairment -pregnant/lactating`
The nurse is administering telithromycin (Ketek) to a child with Streptococcus pneumoniae infection. What nursing intervention is implemented when administering this medication?
Administer the medication with or without food
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction?
Antacids decrease the absorption of the drug.
lincosamide drugs
Clindamycin (cleocin)
An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin?
Diarrhea
In which condition present in the client should macrolides be used with caution?
Liver dysfunction
Which statement is true concerning macrolides?
Macrolides are bactericidal or bacteriostatic.
tetracyclines actions
inhibit bacterial protein synthesis
The client is taking spectinomycin for the treatment of gonorrhea. The client called the clinic this morning complaining of insomnia. What is the nurse's best response to this client?
"This is a common adverse reaction to the medication and should go away when you finish the prescription."
The nurse should monitor a client for which finding when aminoglycosides are administered concomitantly with furosemide?
- tinnitus - vertigo
tetracyclines uses
-antibiotic for when penicillin can't be used -treats infections caused by rickettsiae, skin infections, H.pylori
macrolides drugs
-azithromycin (zithromax) -clarithromycin (biaxin) -erythromycin base (eryped)
don't give tetracyclines with what
-dairy -antacids -laxatives -iron
tetracycline drugs
-demeclocycline -doxycycline (vibramycin)
tetracyclines precautions/containdictations
-hypersensitivity -pregnancy/lactation -not given to kids younger than 9 -renal/hepatic impairments
macrolides uses
-infections of respiratory and genital tracts -acne-prophylaxis for dental procedures -if pt is allergic to penicillin or cephalosporins
lincosamides uses
-serious infections that penicillin wont work for -used with other antibiotics
A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI?
Chlamydia
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child?
Discoloration of the teeth
A 32-year-old female client has been diagnosed with a superinfection and has been prescribed tigecycline. What is a priority nursing action?
Educate the client about the need to supplement oral contraceptives with another form of birth control.
The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?
Has the child taken tetracycline for treatment?
The nurse is caring for a 62-year-old who has orders to receive gentamicin . The client reports difficulty hearing. What should the nurse do?
Hold the dose and notify the health care provider immediately.
The nurse is preparing to administer daptomycin and asks the client to confirm that he has no known allergies. The client replies that he just remembered that he once developed a rash when taking a drug but he doesn't remember which drug it was. What is the nurse's best action?
Hold the medication and contact the healthcare provider.
The nurse learns that a 7-year-old child has been prescribed tetracyclines several times in recent years. What assessment should the nurse prioritize?
Inspect the client's teeth.
The pharmacology instructor is discussing ways to decrease adverse effects on clients taking aminoglycosides. Which would the instructor include?
Keeping the client well hydrated
The nurse should monitor the client for which common side effects of erythromycin therapy?
Nausea, vomiting, and diarrhea
John, 34 years old, is being treated with clindamycin for osteomyelitis of his tibia following an open fracture 3 months ago. The nurse is teaching John how to properly administer the medication at home and the side effects that he needs to report to the health care provider. Which would be the best instruction to give John?
Notify the provider if you have any blood in your stool or diarrhea.
When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?
Ototoxicity and nephrotoxicity
A health care provider is deciding what medication to prescribe for a client with an upper respiratory infection. What principles guide the provider's decision?
Resistance of the bacteria Other drugs the client is taking daily The client's ability to tolerate the drug
A nurse has administered an antibiotic intravenously to a client. The nurse observes signs of tenderness, pain, and redness at the needle site. Which action should the nurse perform immediately?
Stop the infusion and restart the IV in another vein.
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic?
The client has chronic renal failure
Your client is scheduled to undergo major abdominal surgery. A preoperative order for neomycin has been given. Neomycin is used preoperatively for the following reason:
To suppress intestinal bacteria.
A client is receiving long-term clindamycin therapy for a life-threatening infection. What will the nurse begin monitoring, while the client is on this medication?
a baseline complete blood count.
macrolides actions
change protein function and synthesis
A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.
drop in blood pressure increase in respiratory rate sudden increase in temperature
The nurse receives a call from a client who is taking clindamycin (Cleocin). The client reports a burning feeling when swallowing. The nurse knows that the client has developed which adverse reaction related to this medication?
esophagitis
After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication?
gram-negative infections
lincosamides actions
inhibit protein synthesis , causing cell death
A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?
on an empty stomach.
Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?
penicillins
tetracyclines can cause :
permanent yellow/gray/brown discoloration of teeth
A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment?
urine output and BUN and creatinine levels