Questions and Answers
What is the client who is taking digoxin referred to as?
The client who is taking digoxin
What should a client do when taking oral erythromycin?
I should drink a full 8-oz glass of water when I take the medicine.
What is the treatment of choice for traveler's diarrhea?
Rifaximin
What adverse reaction should be expected in a client taking clindamycin who is experiencing dehydration?
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What side effect should a nurse monitor for when a client is prescribed chloramphenicol for VRE?
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If a client is allergic to penicillin, which antibiotic is likely to be ordered?
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What nursing assessment is most appropriate for a client diagnosed with pneumonia who might receive erythromycin?
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What medication is generally prescribed to a client with a bad reaction to penicillin before a dental procedure?
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Linezolid (Zyvox) can be used to treat which of the following infections? (Select all that apply)
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What symptoms does a client show when experiencing red-man syndrome from vancomycin?
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What illness is indicated if a client receives tigecycline for a resistant skin infection?
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What is the recommended administration duration for intravenous (IV) vancomycin to prevent complications?
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What goals should be included in the care plan for a patient receiving miscellaneous antimicrobials? (Select all that apply)
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Which type of bacteria are most commonly resistant to vancomycin?
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If a wound culture reveals methicillin-resistant Staphylococcus aureus, which medication would the nurse expect to be prescribed?
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What tests need to be conducted before administering the first dose of an anti-infective drug?
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What should the nurse's best response be when a client states they do not like to take a lot of drugs?
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Which of the following drugs are considered to be macrolides? Choose all that apply.
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Which goals would be appropriate to include in the plan of care for a patient receiving miscellaneous antimicrobials? Select all that apply.
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In which condition should macrolides be used with caution?
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What common side effects should the nurse monitor for in a client receiving erythromycin therapy?
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What is the cause of red man syndrome associated with intravenous administration of vancomycin?
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Which drug is expected to be ordered for a client with severe and life-threatening pseudomembranous colitis caused by C. difficile?
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Why is vancomycin given orally in the treatment of bacterial colitis?
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What course of action is best to determine if an antibiotic-resistant pathogen is present?
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Rifaximin is effective to treat traveler's diarrhea from which organism?
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Are macrolides bacteriocidal or bacteriostatic?
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What medication would the nurse expect for a client allergic to penicillin with an upper respiratory infection?
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What should the nurse teach the client receiving erythromycin before dental surgery who has a history of cardiac surgery?
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What type of organism does metronidazole effectively treat?
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What is an important nursing intervention for a patient administered linezolid?
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What should the nurse inspect for in a patient taking macrolides who develops diarrhea?
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What instruction should be given to John, who is on clindamycin for osteomyelitis?
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What foods should a patient on linezolid avoid? Select all that apply.
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What characteristics describe clindamycin? Choose all that apply.
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What medication will decrease the effects of azithromycin when administered concurrently?
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What is the recommended dose of erythromycin ethylsuccinate for a child weighing 20 kg?
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Which medications could be used to treat a client with vancomycin-resistant enterococci (VRE)? Select all that apply.
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What information will the nurse teach a client switched to azithromycin from erythromycin?
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What principles guide the provider's decision on what medication to prescribe for a respiratory infection? Select all that apply.
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Which client should not receive erythromycin as ordered?
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What should the nurse do if a patient taking erythromycin has difficulty hearing?
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What instruction is most important for a client prescribed daptomycin?
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What is the most important lab value to monitor during linezolid therapy?
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What is the most common adverse reaction to IV vancomycin?
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Which client should be assessed further before receiving azithromycin as ordered?
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Study Notes
Antibiotic Overview
- Vancomycin is often prescribed for methicillin-resistant Staphylococcus aureus (MRSA) infections, acting on gram-positive microorganisms by inhibiting cell wall synthesis.
- Culture tests are essential before administering anti-infective drugs to identify the causative organism.
Patient Education and Compliance
- Educate clients about the importance of completing the entire course of antibiotic treatment to prevent recurrence of infections.
Macrolides
- Common macrolides include erythromycin, azithromycin (Zithromax), and clarithromycin (Biaxin).
- Macrolides can be bacteriocidal or bacteriostatic depending on the dose and organism susceptibility.
- Erythromycin is a safe alternative for patients allergic to penicillin.
Monitoring and Side Effects
- Monitor for common side effects of erythromycin therapy, including nausea, vomiting, and diarrhea.
- "Red man syndrome," a common reaction to vancomycin, is caused by histamine release and manifests as flushing and cardiovascular effects.
Specific Infections and Treatments
- Oral vancomycin is the treatment of choice for severe pseudomembranous colitis caused by C. difficile.
- Rifaximin is effective for traveler's diarrhea caused by Escherichia coli and is ineffective against invasive bacteria.
- Metronidazole is preferred for antibiotic-associated colitis when symptoms worsen post-antibiotic treatment.
Special Populations
- Use macrolides cautiously with clients who have liver dysfunction as pre-existing liver disease is a contraindication.
- Erythromycin should be avoided in clients with elevated liver enzymes due to risk of accumulation and toxicity.
Antimicrobial Resistance and Interaction
- Linezolid may pose a risk of severe hypertension when interacting with tyramine-rich foods.
- Newly prescribed antibiotics should take into account the client’s existing medications to prevent adverse drug interactions.
Clindamycin and Adverse Reactions
- Clindamycin can lead to serious gastrointestinal side effects, particularly pseudomembranous colitis, requiring immediate reporting of any diarrhea or blood in stools.
Clinical Assessment and Therapy Appropriateness
- Assess liver function through lab results before prescribing erythromycin.
- Monitor complete blood count for patients on linezolid due to the risk of myelosuppression.
- Report any muscle pain or tingling when treating with daptomycin, as these may indicate serious side effects.
Patient Counseling
- Instruct patients on azithromycin to take the drug once daily, which is beneficial for compliance.
- Advise clients receiving antacids concurrently with azithromycin that it may decrease drug efficacy.
Hierarchy of Treatment Options
- For penicillin-allergic individuals with infections requiring similar coverage, erythromycin serves as the preferred alternative.
- Chloramphenicol is reserved for cases with no suitable alternatives due to its potential for serious side effects and blood dyscrasias.
Summary of Key Drug Effects
- Key side effects of vancomycin include nephrotoxicity and ototoxicity.
- Rifaximin and clindamycin require close monitoring for specific adverse effects, including gastrointestinal symptoms and systemic reactions.### Erythromycin and Endocarditis Prevention
- Erythromycin serves as prophylaxis against alpha-hemolytic streptococcal endocarditis.
- Administered prior to dental or other procedures for patients with valvular heart disease.
- Important for individuals allergic to penicillin.
Linezolid (Zyvox) Treatment Applications
- Effective against community-acquired pneumonia (CAP).
- Treats vancomycin-resistant Enterococcus faecium (VREF).
- Used for methicillin-resistant Staphylococcus aureus (MRSA).
- Also applicable for nosocomial pneumonia.
Red-Man Syndrome and Vancomycin
- Symptoms include neck and back pain, feeling hot, chills, and a red neck.
- Accompanied by a high fever (102 degrees F) and low blood pressure (BP 86/58).
- Indicates the possibility of Red-Man syndrome associated with vancomycin administration.
Administration of Intravenous Vancomycin
- Administering IV vancomycin over 60 minutes prevents a severe drop in blood pressure.
- Importance of careful monitoring of administration rates for safety.
Goals in Antibacterial Care
- Patients should take antimicrobials accurately for the prescribed duration.
- Regular monitoring for therapeutic effects and potential adverse drug responses is essential.
- Patients should demonstrate understanding of measures to prevent recurrent infections.
Bacterial Resistance
- Enterococci are the bacterial type most commonly resistant to vancomycin.
- Resistance development in bacteria necessitates vigilant antibiotic stewardship.
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Description
This quiz covers essential information about antibiotics, focusing on their mechanism of action, the importance of culture tests, and patient education on compliance. Topics include macrolides like erythromycin and adverse effects related to antibiotic therapy. Test your knowledge on these critical aspects of antibiotic use and patient care.