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Which nursing action would be most important before administering an intravenous dose of penicillin?
Which intervention is the most important when caring for a 22-year-old woman who has been prescribed amoxicillin?
Which sign or symptom would require immediate intervention by the nurse after administering amoxicillin?
Which patient parameter would lead the nurse to hold the dose of ceftriaxone and contact the health care provider?
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Which term is used to describe when an antibacterial drug is no longer effective due to repeated use?
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Which laboratory value would the nurse assess to ensure safe administration of vancomycin to a patient?
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What action would the nurse take if the patient develops excessive sweating and reports itching of the face and neck while vancomycin is being administered?
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Which teaching will the nurse provide to a patient who has been prescribed azithromycin for otitis media?
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Which cue indicates cranial nerve VIII toxicity in a patient receiving vancomycin?
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Which information would the nurse include when teaching a patient about the administration of an antacid and ciprofloxacin?
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For which patient would the nurse question the prescription of tetracycline?
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Which instruction would the nurse include in the discharge teaching for a patient receiving tetracycline?
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After teaching a patient prescribed doxycycline for the treatment of a skin infection, which patient response reflects an understanding of doxycycline administration? (Select all that apply)
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Following education from the nurse for a new prescription of tetracycline, which patient statement reflects a need for clarification?
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A patient prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) indicates the patient requires further instruction with which statement?
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A patient prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) reports feeling tired along with a painful and blistering rash. Which complication is likely occurring?
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Which statement describes how superinfection can occur?
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Which assessment is most important before administering the first dose of ampicillin to an 80-year-old patient?
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Which occurrence(s) would the nurse mention as causative of bacterial resistance when explaining antibiotic therapy to a patient? (Select all that apply)
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Which occurrence would the nurse identify as the cause of reported oral candidiasis in a patient who has been taking an antimicrobial drug for 2 weeks?
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Which organ can be damaged by antibacterial drugs? (Select all that apply)
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The nurse is reviewing a patient's medical history before administering azithromycin. Which patient factor would most likely contribute to hepatotoxicity?
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Which drug interaction is most likely to contribute to vancomycin nephrotoxicity?
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Which action by the nurse is inappropriate in caring for a patient receiving levofloxacin for a urinary tract infection (UTI)?
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Which complication would the nurse monitor for in a patient who is on nonsteroidal antiinflammatory drug (NSAID) therapy and has been prescribed levofloxacin?
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Which assessment will the nurse include when planning care for a patient who is receiving daily gentamicin infusions?
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Which laboratory test is used to monitor for antibiotic toxicity?
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Which statement correctly describes fluoroquinolones? (Select all that apply)
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Which cue in a patient’s medical record would cause concern for a patient receiving gentamicin?
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Which action would the nurse suspect as the cause of shortness of breath, facial flushing, severe headache, vomiting, and confusion in a patient receiving metronidazole treatment?
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Which explanation will the nurse provide if a patient asks why a combination medication, trimethoprim-sulfamethoxazole (TMP-SMZ), is prescribed for a urinary tract infection?
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Which intervention(s) would be appropriate when caring for a patient who has been prescribed penicillin G potassium? (Select all that apply)
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Study Notes
Antibacterials Overview
- Superinfection occurs when antibiotics eliminate normal bacterial flora, allowing other bacteria or fungi to cause infection.
- Complete a full course of antibiotics to prevent bacterial resistance.
- Renal function is critical to assess before administering ampicillin, especially in older adults due to their sensitivity to medications.
Causes of Bacterial Resistance
- Stopping antibiotics after feeling better and skipping doses can contribute to resistance.
- Using antibiotics for viral infections also promotes resistance.
- Administering antibiotics according to culture and sensitivity helps combat resistance.
Complications and Toxicities
- Oral candidiasis during antibiotic treatment often indicates a superinfection.
- Antibacterial drugs can lead to liver and kidney toxicity; the eyes, brain, and spleen are usually unaffected.
- Drug interactions with acetaminophen increase the risk of hepatotoxicity with azithromycin.
Monitoring and Assessment
- Monitor urine output; less than 600 mL in 24 hours may suggest renal insufficiency in patients receiving gentamicin.
- Assess hearing for patients on aminoglycosides to watch for ototoxicity.
- Trough levels of antibiotics should be measured to maintain therapeutic levels, while peak levels indicate toxicity.
Medication Interactions
- Furosemide can enhance nephrotoxicity when used with vancomycin.
- Levofloxacin can interact with caffeine, increasing its effects, and should not be taken with antacids or iron to avoid absorption issues.
- Metronidazole can cause disulfiram-like reactions if alcohol is consumed, leading to severe symptoms.
Specific Antibiotic Considerations
- Fluoroquinolones treat both gram-positive and gram-negative organisms but should be used cautiously.
- Trimethoprim-sulfamethoxazole is prescribed in combination to reduce bacterial resistance.
- Penicillin G potassium requires monitoring for superinfections and has a risk of allergic reactions; have epinephrine available for emergencies.
Important Nursing Actions
- Always assess for allergies before administering any antibiotic, particularly penicillin, to avoid hypersensitivity reactions.
- For amoxicillin prescribed to women, evaluate the use of oral contraceptives as effectiveness may decrease.
- Advise patients to take medications with food when necessary to prevent gastrointestinal distress.### Antibiotic Side Effects and Interventions
- Long-term antibiotic use may lead to blood dyscrasias, but baseline assessments like CBC are not prioritized.
- Angioedema from amoxicillin is a critical, life-threatening reaction indicating airway compromise requiring immediate action.
- Other common side effects of amoxicillin include nausea, candidiasis, and tongue discoloration, but these are not emergencies.
Key Medication Considerations
- A cefazolin allergy suggests a risk for allergy to ceftriaxone and necessitates holding the dose.
- Acquired resistance in bacteria develops from repeated antibiotic use, while inherent resistance occurs naturally without prior exposure.
- Renal function monitoring is essential before administering vancomycin due to its potential nephrotoxicity.
Nursing Actions for Adverse Reactions
- In cases of excessive itching and sweating during vancomycin infusion, stopping the infusion is paramount to manage red man syndrome, which may occur with rapid administration.
- Patients prescribed azithromycin should be instructed to complete the full course even if symptoms improve.
Toxicity Monitoring
- Cranial nerve VIII toxicity from vancomycin presents with tinnitus and hearing loss; facial pain or vision changes are not indicative.
- Tetracycline is contraindicated in children under 8 due to potential tooth discoloration.
Patient Education about Antibiotics
- Patients should complete all prescribed doses of antibiotics, such as doxycycline, to prevent infections from worsening.
- Caution individuals taking tetracycline regarding sun exposure, as it can cause photosensitivity; using sunscreen is advised.
- For drugs like ciprofloxacin, it’s important to take 2 hours apart from antacids to ensure optimal absorption.
Recognizing Serious Complications
- Trimethoprim-sulfamethoxazole (TMP-SMZ) may lead to Stevens-Johnson syndrome, indicated by fatigue and a painful blistering rash, necessitating immediate medical attention.
- The need for additional birth control methods should be communicated to patients taking tetracycline due to potential interference with oral contraceptive efficacy.
General Test-Taking Strategies
- Eliminate clearly incorrect answers first in multiple-choice scenarios to narrow down options.
- When in doubt, carefully analyze the question stem and ensure the selected answer is comprehensive and relevant to the query.
- Manage time effectively during tests to enhance performance and reduce anxiety.
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Description
Test your knowledge on antibacterials with this quiz. This assessment covers key concepts related to superinfection and antibiotic mechanisms. Perfect for students preparing for their microbiology or pharmacology exams.
