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Questions and Answers
Which statement accurately describes ketoconazole?
What is a major contraindication for the use of fluconazole?
Which drug is a prophylactic agent for reducing candidiasis in bone marrow transplant recipients?
What is a major side effect associated with itraconazole?
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Which of the following is NOT a common issue linked with ketoconazole?
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What is one of the essential rights of drug administration?
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Which of the following conversions is correct?
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How can the right client be verified before administering medication?
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What happens if there's a verbal or phone medication order?
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Which of the following would NOT be considered a right of drug administration?
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Which conversion accurately reflects a unit of weight in the metric system?
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The right evaluation is important in nursing practice for what reason?
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What is the role of computerized systems in drug administration?
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Which mechanism prevents a drug from entering the cell?
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What is a crucial factor in preventing resistance to antimicrobial therapy?
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What method is used to identify the infecting pathogen?
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What does sensitivity of a pathogen indicate?
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What is a benefit of combination therapy?
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Which of the following is NOT a common adverse reaction to anti-infective therapy?
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Who should receive prophylaxis with anti-infective agents?
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How are antibiotics defined?
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What is the equivalent amount in mg for 62.5 mcg?
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What is a common clinical presentation that indicates sepsis in a patient?
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How many tablets are needed to equal a required dose of 0.125 mg if one tablet contains 0.0625 mg?
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Using the formula for fluid dosage calculations, what volume would you administer for a dose of 15 mg of medication with a stock concentration of 25 mg in 2 ml?
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Which key aspect should be included in health teaching about Vancomycin?
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What is the correct formula for calculating flow rates in drops per minute?
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Before initiating treatment with a bacteriocidal antibiotic like Vancomycin, what should the nurse assess?
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Why might a physician choose not to prescribe a previously used antibiotic for a patient?
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If 1500 ml of IV Saline is ordered over 12 hours with a drop factor of 15 drops/ml, how many drops per minute needs to be delivered?
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What units must the required dose and stock dose be in to use the fluid dosage calculation formula correctly?
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What symptoms are indicative of the body’s reaction to sepsis that the medical team should monitor?
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Given 75 mg of pethidine ordered with a stock concentration of 100 mg in 2 ml, what is the volume to be administered?
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What is NOT a potential side effect of Vancomycin that patients should be warned about?
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Which statement regarding intravenous fluid administration is correct?
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In cases of sepsis, what is a primary assessment the healthcare team should perform on RM?
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What is the main action of Vancomycin as an antibiotic?
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Study Notes
Metric Conversions
- 1 kg = 2.2 lb
- 1 tsp = 5 mL
- 1 L = 1000 mL
- 1 kg = 1000 g
- 1 oz = 30 mL
- 1 g = 1000 mg
- 1 mg = 1000 mcg
- 1 tbsp = 15 mL
- 1 cup = 8 fl oz
- 1 pint = 2 cups
- 12 inches = 1 foot
- 1 tbsp = 3 tsp
- 1 cc = 1 mL
- 8 oz = 237 mL
- 1 tsp = 60 gtt
Drug Administration Rights
- Rights of Drug Administration: Right client, Right drug, Right dose, Right time, Right route
- Additional Rights: Right assessment, Right documentation, Client's right to education, Right evaluation, Client's right to refuse
Drug Administration
- Right Client: Ensure the correct client by checking the wristband and a second piece of identification
- Right Drug: Ensure the client receives the prescribed drug from a licensed professional
- Medication Errors: Computerized systems can reduce medication errors
- Phone Orders: Must be cosigned by the prescribing physician within 24 hours
- Dosage Calculation Example: 0.125 mg = 2 tablets (if a dose is 0.0625 mg)
Fluid Dosage Calculations
- Formula: Required Dose / Stock Dose x Stock Volume = Volume to be given
- Units Must Be the Same
- Example 1: A client requires 15 mg of Stemetil. 2 ml of solution contains 25 mg. 15 mg/25 mg x 2 ml = 1.2 ml
- Example 2: A dose of 75 mg of pethidine is ordered. The ampule contains 100 mg in 2 ml. 75 mg/100 mg x 2 ml = 1.5 ml
Intravenous Fluid Computation
- Rate: Intravenous fluids must be administered at a specific rate
- Measurement: ml/hour, L/hour, or drops/min
- Drop Factor: Controlled via drops per minute, determined by the burette (needle or dropper)
- Common Factors: 10 drops/ml (blood set), 15 drops/ml (regular set), 60 drops/ml (microdrop)
- Flow Rate Formula: Volume (ml) x Drop Factor (drops/ml) / Time (min) = drops/minute
- Example: 1500 ml IV Saline over 12 hours. Drop factor = 15 drops/ml. (1500 ml x 15 drops/ml) / 720 min = 31.25 drops/minute
Anti-Infective Agents
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Mechanisms of Action:
- Inhibiting cell wall synthesis
- Inhibiting protein synthesis
- Inhibiting nucleic acid synthesis
- Interfering with metabolism
- Changing cellular permeability to prevent the drug from entering the cell
- Altering transport systems to exclude the drug from active transport into the cell
- Altering binding sites on the membranes or ribosomes, which then no longer accept the drug
- Producing a chemical that acts as an antagonist to the drug
Preventing Resistance
- Limiting the use of antimicrobial agents to specific pathogens sensitive to the drug.
- Ensuring sufficient doses and duration of therapy.
- Cautiously using anti-infectives.
Identification of the Pathogen
- Culture: A tissue sample from the infected area is grown on an agar plate.
- Microscopic Examination: Staining techniques identify the bacterium.
- Stool Examination: Can identify ova and parasites.
Sensitivity of Pathogen
- Shows which drugs can control the microorganism.
- Important for microorganisms with known resistant strains.
- Identifies the pathogen and appropriate drug for treatment.
Factors Affecting Prescribing Anti-infective Agents
- Identifying the correct pathogen.
- Selecting the right drug:
- One that causes the least complications
- One that is most effective against the pathogen involved
Combination Therapy
- Using a smaller dosage of each drug.
- Some drugs are synergistic.
- In infections caused by multiple organisms, each pathogen may react to a different anti-infective agent.
- Delaying the emergence of resistant strains.
Adverse Reactions to Anti-infective Therapy
- Kidney damage
- Gastrointestinal (GI) tract toxicity
- Neurotoxicity
- Hypersensitivity reactions
- Superinfections
Prophylaxis of Anti-infective Agents
- People traveling to areas with endemic malaria.
- Patients undergoing gastrointestinal or genitourinary surgery.
- Patients with known cardiac valve disease, valve replacements, and other conditions requiring invasive procedures.
Antibiotics
- Chemicals that inhibit specific bacteria.
Case Scenario 3
- Clinical Presentation of Sepsis: High fever, low blood pressure, fast respiratory rate, disorientation, shortness of breath
Health Teaching About RM's Antibiotics
- Inform the client about the importance of completing the full course of antibiotics even if they feel better.
- Emphasize the potential side effects of the antibiotic.
- Alert the client to the importance of reporting any adverse reactions.
Drug Study Guide on Vancomycin
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Key Facts:
- Bactericidal antibiotic
- Treats serious infections caused by Gram-positive bacteria
- Can cause nephrotoxicity and ototoxicity
- Adverse Reactions: Red man syndrome (flushing, hypotension, rash), allergic reactions, thrombophlebitis
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Nursing Implications
- Administered intravenously
- Monitor for red man syndrome
- Monitor renal and auditory function
- Infuse slowly to minimize adverse effects.
- Assess for allergy
- Monitor patient for therapeutic effect
Anti-Infective Multiple Choice
- Answer: c. Hypersensitivity
- Rationale:* Bactericidal antibiotics can cause hypersensitivity, which is a serious adverse reaction.
- Answer: c. "It's important to use the right medicine for the right infection. Bacteria can become resistant to antibiotics, so we have to choose the best one for you."
- Rationale:* Resistance to antibiotics is a growing problem and the best antibiotic for an infection needs to be appropriate for the specific bacteria causing the infection.
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Description
This quiz covers essential concepts in drug administration rights and metric conversions. You will learn about the rights of medication administration and how to accurately convert between various metric units. Test your knowledge on both the safe administration of drugs and the metric system essentials.
