PrepU Chapter 9: Antibiotics

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 pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?

"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."

A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide?

10 lb weight loss

When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?

Alcohol

A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?

BUN and creatinine

An older adult client is prescribed intravenous ciprofloxacin for the treatment of a urinary tract infection. What nursing assessment should the nurse prioritize to identify potential adverse effects?

Blood glucose monitoring

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

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

Ethambutol should be used cautiously in which clients? Select all that apply.

Clients with renal impairment Clients with cataracts Clients with hepatic impairment

An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?

Confirm the client's allergy status

When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline?

Creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

A client is receiving ciprofloxacin for a urinary tract infection. This drug is administered IV. During the infusion, the nurse notes fluid leaking into the tissue around the IV site. What is the best response of the nurse?

Discontinue the IV

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

Gastrointestinal upset

Which of the following drugs would be classified as an aminoglycoside?

Gentamicin

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

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.

Increase in respiratory rate Sudden increase in temperature Drop in blood pressure

Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason?

Increasing resistance

The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?

Inhibiting cell wall synthesis

The nurse is caring for a client who has been prescribed metronidazole. Which intervention implemented by the nurse indicates an understanding of a possible adverse effect associated with therapy?

Instituting seizure precautions

A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice?

It is metabolized in the liver

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication?

Jaundice

What is a contraindication to use of a fluoroquinolone?

Lactation

A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely?

Liver function studies

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example?

Metronidazole

A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?

Monitor for appearance of adverse reactions

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?

Penicillins

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

Phlebitis

The use of rifampin is contraindicated in which? Select all that apply.

Renal impairment Hepatic impairment

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

Serum alanine transaminase, aspartate transaminase, and bilirubin

A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as:

Superinfection

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

Which statement is true in regards to the oral administration of tetracyclines?

Tetracyclines should be administered with a full glass of water

A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?

The need to consistently take the prescribed drugs in order to cure TB

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 normal flora of the body

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?

To prevent resistance

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 giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?

Vaginal itching and discharge

Aminoglycosides must be used cautiously in children as in adults. Dosage must be accurately calculated according to which factors?

Weight and renal function

A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence?

Superinfection following the eradication of normal oral flora

An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed?

Trimethoprim-sulfamethoxazole