Prep U - Pharm Final

The nurse knows that the recommended time to administer a sulfonamide to a patient is which of the following?

1 hour before or 2 hours after meals. Explanation: Unless the order reads otherwise, the nurse should give sulfonamides to the patient whose stomach is empty--that is 1 hour before meals or 2 hours after meals. If gastric irritation occurs, then the nurse may give sulfonamides with food or immediately after meals.

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

1 to 2 hours. For systemic infections, vancomycin is given IV and reaches therapeutic plasma levels within 1 hour after infusion. It is very important to give IV infusions slowly, over 1 to 2 hours, to avoid an adverse reaction characterized by hypotension, flushing, and skin rash. This reaction, sometimes called "red man syndrome," is attributed to histamine release.

Within 48 hours of taking erythromycin for an upper respiratory infection, what assessment finding indicates the patient has started having therapeutic effects?

Decrease in fever

After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class?

Gentamicin. Explanation: Gentamicin is considered the prototype aminoglycoside.

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

Methenamine (Hiprex) should be used cautiously in patients with which of the following medical conditions?

Gout. Explanation: Methenamine (Hiprex) should be used cautiously in patients with gout because it may cause crystals to form in the urine.

The pharmacology instructor is teaching about sulfonamides and informs the students that these drugs are used to control infections caused by which of the following bacteria?

Gram negative and Gram positive. Explanation: The sulfonamides are used to treat both gram-negative and gram-positive bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella and Enterobacter species.

Aminoglycosides are used primarily in the treatment on what type of infection?

Gram-negative infections. Explanation: Aminoglycosides are used primarily in the treatment of infections caused by gram-negative microorganisms.

You know that penicillins are more effective when used on what type of bacteria?

Gram-positive bacteria. Explanation: As a class, penicillins usually are more effective in infections caused by gram-positive bacteria than those caused by gram-negative bacteria.

A common reaction associated with the intravenous administration of vancomycin is "red man syndrome." What is the cause of red man syndrome?

Histamine release

Your patient is receiving a multiple-dose regimen of an aminoglycoside. On what serum drug levels will you base the patient's maintenance dose?

In patients receiving aminoglycosides, both peak and trough serum levels are measured to maintain therapeutic levels without excessive toxicity.

Inappropriate use of antibiotics does all of the following EXCEPT:

Increase the number of available effective drugs for serious or antibiotic-resistant infections.

A patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline?

Increased risk of bleeding. Explanation: The patient is at an increased risk of bleeding from an interaction of oral coagulants with tetracyclines.

A client presents to the physician's office with a skin infection on her forearm. The infection is resistant to over-the-counter antibiotics. After receiving the culture and sensitivity results, the physician orders tigecycline. The nurse knows that this client has what illness?

MRSA Explanation: Tigecycline belongs to the glycylcycline class of antibiotics. It is similar to tetracycline in structure and properties and can be used to treat skin infections caused by MRSA.

Which statement is true concerning macrolides?

Macrolides are bacteriocidal or bacteriostatic. Explanation: Macrolides are absorbed well in body tissues and fluids and kill gram-positive bacteria. Depending on the concentration in the body, they can be bacteriocidal or bacteriostatic.

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 patient reports urinating only once in the last 16 hours. What should the nurse consider as the cause?

Nephrotoxicity Explanation: Nephrotoxicity may develop from administration of cephalosporins. An early sign of this adverse reaction is decreased urine output. The nurse should measure and record fluid intake and output and notify the primary health care provider if output is less than 500 ml/day.

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 Explanation: When cephalosporin is administered with aminoglycosides, it increases the risk for nephrotoxicity and should be closely monitored. Nausea is an adverse reaction of cephalosporins in patients with gastrointestinal tract infection. The risk of bleeding increases when cephalosporin is administered with oral anticoagulants. Risk for respiratory difficulty increases if alcohol is consumed within 72 hours after certain cephalosporin administration.

A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client complains of pain and the nurse notes a reddened area along the vein. What does the nurse suspect?

Phlebitis

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse focuses education on which adverse reaction?

Photosensitivity

After teaching a group of students about resistance, the instructor determines that the students need additional teaching when they identify which of the following as a way that microorganisms develop resistance?

Production of a chemical to act as an agonist

A 34-year-old female patient is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The patient reports gastrointestinal distress. The nurse will encourage the patient to....?

Take the drug with food.

The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function?

Within one to five minutes, an effect may be seen. Explanation: Onset of action is generally rapid and may be seen within one to five minutes. Additional doses may be required to achieve optimal effects. T

A healthcare provider is deciding what medication to prescribe for the patient with an upper respiratory infection. What principles guide the provider's decision?

• Resistance of the bacteria • Other drugs the patient is taking daily • The patient's ability to tolerate the drug

You are preparing to discharge a patient who is taking ciprofloxacin. What guidance would you offer this patient to prevent crystalluria?

"Drink at least 2 liters of fluids per day." Explanation: Crystalluria is a potential side effect of taking fluoroquinolones such as ciprofloxacin. Patients should be instructed to drink two to three quarts of fluids each day to decrease the risk of developing the condition. Although the nurse should instruct the patient to take the medication as prescribed and to avoid antacids, which can decrease absorption of the medication, neither measure will prevent crystalluria.

A client has been prescribed daptomycin for treatment of an infection. What instruction is most important for the nurse to tell this client?

"Tell the physician immediately if you develop any muscle pain." Explanation: The presence of muscle pain or weakness is an indication that the client is developing a severe musculoskeletal reaction, and the medication must be discontinued immediately.

A patient prescribed erythromycin (E-mycin) states that she "does not feel any better" after taking the drug for 2 days. What should the nurse tell the patient?

"The organism may be resistant to the drug." Explanation: This drug is used less often because of microbial resistance. The drug may need to be changed, and a culture should be done if possible. The patient should see results within a few days and start to feel better if the antibiotic is working.

A patient received erythromycin before dental surgery. The patient has a past history of a cardiac surgery. The rest of the patient's history is unremarkable. What does the nurse teach the patient about this medication?

"You are receiving this medication to prevent the growth of bacteria in your heart."

A nurse has been performing vigilant assessments of a patient who is receiving doses of intravenous gentamicin, each over 30 minutes. A blood sample for peak gentamicin levels should be drawn

30 minutes after the drug has finished infusing. Blood for peak levels of gentamicin is drawn 30 minutes after the completion of a 30-minute intravenous (IV) administration or immediately after a 60-minute IV administration and 45 to 60 minutes after intramuscular (IM) administration. Blood for trough levels is drawn just before the next dose.

The nurse administers cefuroxime to a patient at least one hour before meals, as prescribed. However, the patient experiences a GI upset. Which of the following is an appropriate nursing intervention in this case?

Administer the drug with food. If the patient experiences GI upset, the nurse can administer cefuroxime with food. A decrease in the dosage is suggested in a patient with renal impairment.

A male client presents to the emergency department with an abdominal dehiscence. He states he had a hernia repair 18 days earlier, and the physician removed his wound staples 5 days ago. The client states that the dehiscence occurred when he lifted a box this morning for his wife. The wound is red, and there is evidence of foul-smelling drainage. The wound is cultured, and an anaerobic bacterium is identified. The nurse understands that the physician orders metronidazole because it is effective against which type of organism?

Anaerobic bacteria. Explanation: Metronidazole is effective against infections with anaerobic bacteria and some protozoa.

As the nurse caring for Jane, a 24-year-old woman admitted with pneumonia, you are explaining how antibiotics work to help cure her pneumonia. Which statement would be correct about how antibiotic therapy works?

Antibiotics work by inhibiting cell wall synthesis.

Fluoroquinolones treat infection by which of the following effects?

Bactericidal Explanation: The fluoroquinolones exert bactericidal effects.

The nurse should advise patients taking phenazopyridine (Pyridium) that their urine may become discolored, which of the following colors?

Brown. Explanation: The nurse should advise patients taking phenazopyridine (Pyridium) that their urine may become discolored and may appear a dark orange to brown color.

A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The physician orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?

By administering the drug in separate IV bags. Explanation: Aminoglycosides are often given with penicillins for serious infections, such as those caused by Pseudomonas aeruginosa. The drugs should not be mixed in a syringe or in an IV solution, because the penicillin inactivates the aminoglycoside.

The client is experiencing chest pain and has taken three sublingual nitrogylcerin tablets, but the pain remains. What should the client do next?

Call 911. Explanation: Nitroglycerin should be administered every five minutes, times three doses. If the pain persists, 911 or the emergency system should be activated.

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component of bacterial development do these drugs affect?

Cell wall synthesis. Beta-lactam antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes. This binding produces a defective cell wall that allows intracellular contents to leak out.

Prior to administration of the first dose of ampicillin, the nurse questions the client about her drug history. What condition that developed with a previous dose of this medication would contraindicate the use of it again?

Cholestatic jaundice. Explanation: A client who developed cholestatic jaundice with a previous use of ampicillin should not be given this medication again to prevent permanent liver damage.

Which of the following drugs is likely to be administered as a first-line treatment for anthrax exposure?

Ciprofloxacin. Ciprofloxacin is currently recommended as the first-line treatment for suspected anthrax.

While studying pharmacology, the nursing student learns that a naturally occurring narcotic drug with analgesic and antitussive effects is what?

Codeine

The nurse instructs a patient on sulfonamide therapy to drink a full glass of water when taking the medication and to also drink at least 8 large glasses of water each day until therapy is finished. The nurse is trying to prevent which of the following complications associated with sulfonamide therapy?

Crystalluria. Explanation: Sulfonamides may cause the urine and skin to take on an orange-yellow color. Crystalluria may occur during administration of a sulfonamide. Often this problem can be prevented by increasing fluid intake during treatmeent.

A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?

Culture tests

A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?

Decreased absorption of tetracycline. Explanation: Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular-blocking drugs and increased profound respiratory depression are the result of interaction between neuromuscular-blocking drugs and tetracyclines.

When describing the possible adverse effects associated with nitroglycerin, which of the following would the nurse include?

Dizziness

The nurse should advise the client which of the following in regards to the administration of fluoroquinolones?

Do not take antacids while taking fluoroquinolones. Explanation: The client should not take antacids or drugs containing iron or zinc because these drugs will decrease the absorption of the fluoroquinolones.

Rifaximin (Xifaxan) is effective to treat traveler's diarrhea from which of the following organisms?

Escherichia coli. Explanation: Rifaximin (Xifaxan) is a miscellaneous antibiotic and is used to treat E. coli. It cannot be used to treat C. jejuni. Effectiveness against Shigella and Salmonella is unknown.

Some patients stop taking their prescribed sulfonamide once symptoms disappear. What should the nurse tell the patient when first teaching about this medication to prevent the early discontinuation of the drug?

Failure to complete a course of therapy may result in a recurrence of the infection.

Mr. Thiessen is a 60-year-old man whose bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in Mr. Thiessen's condition and the effect of the drug treatment on his blood cultures. During morning care, he has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this patient's complaints?

Hold the next scheduled dose of gentamicin until the physician has been consulted. To avoid permanent ototoxic damage, gentamicin should be withdrawn at the first sign of tinnitus or persistent headache. This supersedes the modification of the patient's care plan and slowing down the infusion of the drug does not mitigate the potential for ototoxic effects.

Why must a client who is receiving aminoglycosides be kept well hydrated?

Hydration decreases drug concentration in serum and body tissues. Keep clients well hydrated to decrease drug concentration in serum and body tissues.

A 49-year-old client is admitted with uncontrolled chest pain. He is currently taking nitroglycerin (Nitrostat). His physician orders nifedipine (Adalat) added to his regimen. You should observe the client for which of the following adverse effects?

Hypotension. Explanation: Cardiovascular effects include hypotension, bradycardia, peripheral edema, and heart block. Skin effects include flushing and rash.

After teaching a patient who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the patient states which of the following?

I need to wear protective clothing when I'm out in the sun. Explanation: Photosensitivity is possible so the patient should use sunscreen and wear protective clothing when outdoors. Fluids should be increased to promote drug excretion. Ice chips or candy is okay for combating a sore mouth. The drug should be taken on empty stomach 1 hour before or 2 hours after meals; antacids should not be taken with the drug because they can affect absorption.

A nurse needs to administer a cephalosporin to a patient. The patient informs the nurse that he is allergic to penicillin. Which of the following actions is the nurse most likely to take in such a situation?

Inform the primary health care provider. Patients with a history of an allergy to penicillin may also be allergic to cephalosporin, so the nurse needs to inform the primary health care provider before the first dose of the drug is given.

A patient who has undergone surgery of the urinary tract is administered cephalosporins to prevent infections. When assessing the patient on the day after the surgery, the nurse notices that he has an elevated temperature. Which of the following nursing interventions would be most appropriate in this case?

Inform the primary healthcare provider. Explanation: The nurse should immediately report an increase in the patient's body temperature to the primary healthcare provider. The nurse should consult the physician before increasing, decreasing, or discontinuing the dosage. The nurse should measure and record the fluid intake if there is a decrease in the urine output.

A patient with acne vulgaris was administered macrolides, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case?

Inspect stools for blood or mucus.

Which of the following represents the mechanism of action of fluoroquinolones?

Interference with the synthesis of bacterial DNA. Fluoroquinolones exert their bactericidal effect by interfering with the synthesis of bacterial DNA; thereby preventing cell reproduction, leading to death of the bacteria.

Which of the following would a nurse identify as a nitrate?

Isosorbide is classified as a nitrate. Metoprolol is a beta-blocker. Amlodipine and nicardipine are calcium channel blockers.

A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient?

It is taken only once a day. Explanation: Since the patient is "forgetful" and lives alone, a daily dose would likely promote compliance. Azithromycin (Zithromax) can be administered once daily because the half-life is 68 hours. Azithromycin (Zithromax) is associated with GI adverse effects and can cause pseudo membranous colitis and neurological symptoms can occur as well. Azithromycin (Zithromax) may adversely interact with cardiac glycosides, oral anticoagulants, theophyllines, carbamazepine, and corticosteroids to name a few.

The nurse is caring for a patient who is receiving an opioid analgesic. Which of the following would be priority assessments by the nurse?

Level of consciousness and respiratory rate Explanation: The nurse should assess respiratory rate and level of consciousness because respiratory depression and sedation are adverse effects of opioid analgesics.

You are the clinic nurse responsible for teaching a patient about his new prescription for doxycycline. Which of the following instructions should you include in your teaching?

Limit your exposure to the sun. Explanation: Tetracyclines increase sensitivity to sunlight, this increases the risk of sunburn. Antacids decrease the effects of tetracyclines.

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

Liver Function. Explanation: Aztreonam, imipenem, meropenem, and ertapenem may cause abnormalities in liver function test results (ex: elevated alanine and aspartate aminotransferases [ALT and AST] and alkaline phosphatase), but hepatitis and jaundice rarely occur.

A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify which of the following as the first antibiotic introduced for clinical use?

Penicillin

The nurse knows that superinfections are a concern for patients who have been taking oral penicillins. Which of the following is one of the more common superinfections?

Pseudomembranous colitis A superinfection can develop rapidly and is potentially life-threatening. Pseudomembrananous colitis is a common bacterial superinfection.

A clinic patient has been prescribed phenazopyridine (Pyridium) for aid in treating a UTI. This patient should be informed that Pyridium will change the urine to what color?

Reddish-orange

A patient with a gram-negative infection is being treated with an aminoglycoside. What system should the nurse expect to be tested daily while on this medication?

Renal system. Explanation: Renal function should be tested daily because aminoglycosides depend on the kidney for excretion and if the GFR is abnormal it may be toxic to the kidney. The results of the renal function testing could change the daily dosage.

You are a home care nurse caring for a patient on IV vancomycin for cellulitis of the left calf. Your responsibilities could include

Responsibilities of the home care nurse may include teaching family members how to administer antibiotics, how to care for the person with an infection, and how to protect other people in the environment from the infection. If the drug is to be administered intravenously, the nurse may also be responsible for teaching the patient or caregivers how to operate infusion equipment and how to monitor the IV site.

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. Explanation: Patients receiving combination therapy of a cefazolin and an aminoglycoside will need to be monitored for nephrotoxicity --- serum BUN and creatinine levels. Serum sodium and potassium levels as well as aspartate aminotransferase should be monitored when receiving sodium penicillin G. PT and PTT should be monitored when a pt is receiving aztreonam, (monobactam antibiotic).

You are caring for a patient who is taking a urinary anti-infectives. As a nurse, what would you need to assess this patient for?

Signs and symptoms of continuing UTI.

Keith, 12 years old, is seen in the emergency department for a severe sunburn. He is complaining of pain, which he rates 7/10. What type of pain is he suffering from?

Superficial somatic pain

Tetracyclines should not be used in children younger than 8 years of age because of their effects on what?

Teeth and bones. Explanation: Tetracyclines should not be used in children younger than 8 years of age because of their effects on teeth and bones.

Which group of drugs should be avoided in children under the age of 8 years?

Tetracyclines. Explanation: Tetracyclines can potentially damage developing teeth and bones and thus should be used cautiously or avoided in children under the age of 8 years.

You are providing discharge teaching to a patient who is being sent home on tetracycline (Sumycin) PO. What should the instructions include?

The need to take the drug on an empty stomach. Explanation: Tetracycline should be taken on an empty stomach 1 hour before or 2 hours after meals with a full 8 ounces of water to ensure full absorption. Tetracycline is usually taken at least every 12 hours.

Which patient is most likely to experience adverse effects from telithromycin (Ketek)?

The patient with colitis Explanation: The patient with colitis is likely to have the most difficulty with the potential gastric side effects of the medication. The medication is given to treat mycoplasma pneumonia.

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

The use of ciprofloxacin is contraindicated in pregnancy.

The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?

They disrupt the microbial flora of the body. Explanation: Pseudomembranous colitis is a superinfection that occurs when the antibiotic disrupts the normal flora, causing a secondary infection or superinfection.

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. Explanation: Neomycin and kanamycin may be given before bowel surgery to suppress intestinal bacteria. Neomycin and kanamycin may be given before bowel surgery and to treat hepatic coma. In hepatic coma, intestinal bacteria produce ammonia, which enters the bloodstream and causes encephalopathy. Drug therapy to suppress intestinal bacteria decreases ammonia production.

What is the recommended medication for the treatment of choice for Pneumocystis jiroveci pneumonia?

Trimethoprim-sulfamethoxazole. Explanation: Trimethoprim-sulfamethoxazole is used to treat Pneumocystis jiroveci pneumonia.

Angina pectoris occurs when the myocardial demand for oxygen exceeds that which can be supplied. True or False.

True

A patient's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he receives an aminoglycoside in conjunction with a potent diuretic. True or False.

True.

Cephalosporins are usually bactericidal. True or false?

True. Explanation: Cephalosporins target the bacterial cell wall similar to penicillin and are usually considered to be bactericidal.

When checking a patient's allergy history, the nurse should assume that if a patient is allergic to penicillins, he or she likely is also allergic to cephalosporins? True or False?

True. Explanation: Because of the close relationship of cephalosporins to penicillins, a patient allergic to penicillin may be allergic to cephalosporins. Approximately 10% of people allergic to a penicillin drug are also allergic to a cephalosporin.

A nurse is monitoring a patient on sulfonamide therapy. Which of the following symptoms should the nurse assess to find out if the patient has thrombocytopenia?

Unusual bleeding.

Your client developed a pressure area on her hip which has become infected. If the wound culture reveals methicillin-resistant Staphylococcus aureus, which of the following medications will you expect to be ordered?

Vancomycin Vancomycin (Vancocin) is active only against gram-positive microorganisms. It acts by inhibiting cell wall synthesis. Parenteral vancomycin has been used extensively to treat infections caused by (MRSA) and methicillin-resistant staphylococcal species non-aureus (SSNA, including Staphylococcus epidermidis), and endocarditis caused by Streptococcus viridans (in patients allergic to or with infections resistant to penicillins and cephalosporins) or E. faecalis (with an aminoglycoside).

Which of the following conditions would occur due to the administration of an opioid antagonist in a patient who is physically dependent on opioids?

Withdrawal symptoms

A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug...?

on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs. Explanation: Oral preparations of tetracycline should be given on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not absorbed well if taken with food or dairy products. The dosage must be given around the clock, and not just at bedtime, to increase effectiveness.

A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to

take vitamins at least 2 hours before or after taking ciprofloxacin. Explanation: If a patient taking vitamins or herbal supplements is prescribed ciprofloxacin, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. Changing or alternating the dosage must be determined by the prescriber.

In preparation for discharge, you are teaching a patient about his prescription for telithromycin. You instruct the patient to contact a health care provider if she experiences

yellowing of the eyes or skin. Explanation: telithromycin can cause liver dysfunction, patients taking the drug should contact a health care provider if they observe any potential symptoms... yellowing of the eyes or skin, abdominal pain, nausea, vomiting, dark urine, pale stools, or unusual tiredness.

A client with pneumonia has been administered linezolid by a nurse. The nurse should monitor the client for which adverse reactions?

• Headache • Chills • Insomnia • Rash

Your patient is receiving a ketolide to treat an infection. Which of the following interventions would be appropriate to include in your plan of care?

• Monitor for fever and other signs and symptoms of infection. • Monitor laboratory reports for indications of the patient's response to drug therapy. • Assist patients to prevent or minimize infections.

Which of the following are true of tetracyclines?

• Tetracyclines are broad spectrum antibiotics. • Tetracyclines may cause permanent discoloration of the teeth in children. • Tetracyclines can be used when penicillins are contraindicated. • Tetracyclines are used to treat Rocky Mountain spotted fever. Explanation: Tetracyclines are broad spectrum antibiotics used to treat rickettsial disease, such as Rocky Mountain spotted fever, and when the use of penicillins is contraindicated. Tetracyclines are not given to children younger than 9 years of age unless absolutely necessary because these drugs may cause permanent yellow-gray-brown discoloration of the teeth.

Your patient is receiving a miscellaneous anitbacterial to treat an infection. Which of the following goals would be appropriate to include in your plan of care? Select all that apply.

• The patient will take or receive miscellaneous antimicrobials accurately, for the prescribed length of time. • The patient will verbalize and practice measures to prevent recurrent infection. • The patient will be monitored regularly for therapeutic and adverse drug effects.