Antibiotics Overview and Education

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?

Diarrhea Signup and view all the answers

What side effect should a nurse monitor for when a client is prescribed chloramphenicol for VRE?

Blood dyscrasias Signup and view all the answers

If a client is allergic to penicillin, which antibiotic is likely to be ordered?

Erythromycin Signup and view all the answers

What nursing assessment is most appropriate for a client diagnosed with pneumonia who might receive erythromycin?

Review lab results to confirm normal liver function. Signup and view all the answers

What medication is generally prescribed to a client with a bad reaction to penicillin before a dental procedure?

Erythromycin Signup and view all the answers

Linezolid (Zyvox) can be used to treat which of the following infections? (Select all that apply)

Vancomycin-resistant Enterococcus faecium (VREF) Signup and view all the answers

What symptoms does a client show when experiencing red-man syndrome from vancomycin?

Neck and back pain, feeling hot, chills, and a red neck. Signup and view all the answers

What illness is indicated if a client receives tigecycline for a resistant skin infection?

MRSA Signup and view all the answers

What is the recommended administration duration for intravenous (IV) vancomycin to prevent complications?

Over 60 minutes Signup and view all the answers

What goals should be included in the care plan for a patient receiving miscellaneous antimicrobials? (Select all that apply)

The patient will verbalize and practice measures to prevent recurrent infection. Signup and view all the answers

Which type of bacteria are most commonly resistant to vancomycin?

Enterococci Signup and view all the answers

If a wound culture reveals methicillin-resistant Staphylococcus aureus, which medication would the nurse expect to be prescribed?

Vancomycin Signup and view all the answers

What tests need to be conducted before administering the first dose of an anti-infective drug?

Culture tests Signup and view all the answers

What should the nurse's best response be when a client states they do not like to take a lot of drugs?

Failure to complete the entire treatment may result in a return of the infection. Signup and view all the answers

Which of the following drugs are considered to be macrolides? Choose all that apply.

Clarithromycin (Biaxin) Signup and view all the answers

Which goals would be appropriate to include in the plan of care for a patient receiving miscellaneous antimicrobials? Select all that apply.

The patient will be monitored for adverse drug effects. Signup and view all the answers

In which condition should macrolides be used with caution?

Liver dysfunction. Signup and view all the answers

What common side effects should the nurse monitor for in a client receiving erythromycin therapy?

Nausea, vomiting, and diarrhea. Signup and view all the answers

What is the cause of red man syndrome associated with intravenous administration of vancomycin?

Histamine release. Signup and view all the answers

Which drug is expected to be ordered for a client with severe and life-threatening pseudomembranous colitis caused by C. difficile?

Oral vancomycin. Signup and view all the answers

Why is vancomycin given orally in the treatment of bacterial colitis?

It acts within the bowel lumen. Signup and view all the answers

What course of action is best to determine if an antibiotic-resistant pathogen is present?

Perform culture and susceptibility tests. Signup and view all the answers

Rifaximin is effective to treat traveler's diarrhea from which organism?

Escherichia coli. Signup and view all the answers

Are macrolides bacteriocidal or bacteriostatic?

Both. Signup and view all the answers

What medication would the nurse expect for a client allergic to penicillin with an upper respiratory infection?

Erythromycin. Signup and view all the answers

What should the nurse teach the client receiving erythromycin before dental surgery who has a history of cardiac surgery?

You are receiving this medication to prevent infection that may affect your heart. Signup and view all the answers

What type of organism does metronidazole effectively treat?

Anaerobic bacteria. Signup and view all the answers

What is an important nursing intervention for a patient administered linezolid?

Causes severe hypertension. Signup and view all the answers

What should the nurse inspect for in a patient taking macrolides who develops diarrhea?

Inspect stools for blood or mucus. Signup and view all the answers

What instruction should be given to John, who is on clindamycin for osteomyelitis?

Notify the provider if you have any blood in your stool or diarrhea. Signup and view all the answers

What foods should a patient on linezolid avoid? Select all that apply.

Chocolate Signup and view all the answers

What characteristics describe clindamycin? Choose all that apply.

A topical solution used to treat acne Signup and view all the answers

What medication will decrease the effects of azithromycin when administered concurrently?

Antacids Signup and view all the answers

What is the recommended dose of erythromycin ethylsuccinate for a child weighing 20 kg?

200 mg per dose. Signup and view all the answers

Which medications could be used to treat a client with vancomycin-resistant enterococci (VRE)? Select all that apply.

Daptomycin (Cubicin) Signup and view all the answers

What information will the nurse teach a client switched to azithromycin from erythromycin?

This drug has enhanced antibacterial activity. Signup and view all the answers

What principles guide the provider's decision on what medication to prescribe for a respiratory infection? Select all that apply.

Resistance of the bacteria Signup and view all the answers

Which client should not receive erythromycin as ordered?

The client with elevated liver enzymes. Signup and view all the answers

What should the nurse do if a patient taking erythromycin has difficulty hearing?

Ask about the patient's hearing prior to medication therapy. Signup and view all the answers

What instruction is most important for a client prescribed daptomycin?

Tell the health care provider immediately if you develop any muscle pain. Signup and view all the answers

What is the most important lab value to monitor during linezolid therapy?

Complete blood count. Signup and view all the answers

What is the most common adverse reaction to IV vancomycin?

Red man syndrome. Signup and view all the answers

Which client should be assessed further before receiving azithromycin as ordered?

The client with a history of liver disease. Signup and view all the answers

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.