Chp. 38-39 test review
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Questions and Answers

Which of the following medications is commonly prescribed for severe urinary tract infections?

  • Clindamycin
  • Metronidazole
  • Ciprofloxacin (correct)
  • Gentamicin
  • What is a common adverse effect of aminoglycoside antibiotics?

  • Ototoxicity (correct)
  • Fever
  • Hypertension
  • Rash
  • Which of the following quinolones can cause a prolonged QT interval?

  • Moxifloxacin (correct)
  • Levofloxacin
  • Norfloxacin
  • Delfloxacin
  • What is the minimum inhibitory concentration (MIC) used to monitor?

    <p>Drug levels</p> Signup and view all the answers

    Which of the following antibiotics can cause pseudomembranous colitis?

    <p>Clindamycin</p> Signup and view all the answers

    What is the black box warning for quinolones?

    <p>Increased risk of tendonitis and tendon rupture</p> Signup and view all the answers

    Which of the following antibiotics is used to treat vancomycin-resistant Enterococcus faecium?

    <p>Linezolid</p> Signup and view all the answers

    What is a common indication for fluoroquinolones?

    <p>All of the above</p> Signup and view all the answers

    Which of the following antibiotics can cause serotonin syndrome when taken with selective serotonin reuptake inhibitors (SSRIs)?

    <p>Linezolid</p> Signup and view all the answers

    What is Plazomicin (Zemdi) used to treat?

    <p>Complicated urinary tract infections</p> Signup and view all the answers

    What is the primary use of Nitrofurantoin?

    <p>Treatment of uncomplicated UTIs</p> Signup and view all the answers

    What is a potential adverse effect of Vancomycin?

    <p>Ototoxicity and nephrotoxicity</p> Signup and view all the answers

    What is essential to obtain before beginning antibiotic therapy?

    <p>Cultures from appropriate sites</p> Signup and view all the answers

    Why is it important to check the name of the medication carefully?

    <p>Because many drugs sound alike or have similar spellings</p> Signup and view all the answers

    What is a nursing implication for Sulfonamides?

    <p>Taking with 2000-3000 ml of fluid/24 hours</p> Signup and view all the answers

    What is a common adverse effect of antibiotics?

    <p>Nausea, vomiting, and diarrhea</p> Signup and view all the answers

    What should patients be instructed to do when taking antibiotics?

    <p>Take the medication exactly as prescribed and for the length of time prescribed</p> Signup and view all the answers

    What is a nursing implication for Tetracyclines?

    <p>Avoiding milk products, iron preparations, antacids, and other dairy products</p> Signup and view all the answers

    What is important to assess before beginning antibiotic therapy?

    <p>Drug allergies, renal, liver, and cardiac function, and other laboratory study results</p> Signup and view all the answers

    What should be monitored for when administering Telavancin?

    <p>Renal toxicity, infusion-related reactions, and QT prolongation</p> Signup and view all the answers

    What is the definition of a community-associated infection?

    <p>An infection that is acquired by a person who has not been hospitalized or had a medical procedure within the past year</p> Signup and view all the answers

    What is the primary difference between healthcare-associated infections and community-associated infections?

    <p>The location where the infection is acquired</p> Signup and view all the answers

    What is the main contraindication for cephalosporins?

    <p>History of throat swelling or hives from penicillin</p> Signup and view all the answers

    What is the main characteristic of methicillin-resistant Staphylococcus aureus (MRSA)?

    <p>It is a type of Gram-positive bacteria</p> Signup and view all the answers

    Which class of antibiotics is reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients?

    <p>Carbapenems</p> Signup and view all the answers

    What is the main adverse effect of tetracyclines during pregnancy?

    <p>Retardation of fetal skeletal development</p> Signup and view all the answers

    What is the primary purpose of antiseptics?

    <p>To inhibit the growth of microorganisms</p> Signup and view all the answers

    What is the term for an infection that develops because of trying to treat a different infection, and all good bacteria have been killed?

    <p>Superinfection</p> Signup and view all the answers

    Which antibiotic is indicated only for the treatment of C.difficile-associated diarrhea?

    <p>Fidaxomicin</p> Signup and view all the answers

    What is the main interaction between cephalosporins and other medications?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the class of antibiotics that includes Sulfonamides?

    <p>Sulfonamides are not a class of antibiotics</p> Signup and view all the answers

    What is the primary indication for Sulfonamides?

    <p>Effective against both gram-positive and gram-negative bacteria</p> Signup and view all the answers

    Which generation of cephalosporins is used to treat uncomplicated and complicated UTIs?

    <p>Fourth generation</p> Signup and view all the answers

    What is the main adverse effect of macrolides?

    <p>GI effects</p> Signup and view all the answers

    What is the primary adverse effect of Sulfonamides on the blood system?

    <p>Hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia</p> Signup and view all the answers

    What is the main interaction between aminoglycosides and other medications?

    <p>No oral forms</p> Signup and view all the answers

    Which of the following is a Penicillinase-resistant drug?

    <p>Nafcillin</p> Signup and view all the answers

    What is the primary indication for Penicillin?

    <p>Prevention and treatment of infections caused by Gram-positive bacteria</p> Signup and view all the answers

    Which antibiotic is used to treat bone, joint, skin, and soft tissue infections?

    <p>Imipenem/Cilastatin</p> Signup and view all the answers

    What is the main patient education instruction for taking tetracyclines?

    <p>All of the above</p> Signup and view all the answers

    Nitrofurantoin is primarily used for treating complicated UTIs caused by E. coli bacteria.

    <p>False</p> Signup and view all the answers

    Quinupristin-dalfopristin is used to treat MRSA and other gram-positive infections.

    <p>True</p> Signup and view all the answers

    Vancomycin may cause hepatotoxicity.

    <p>False</p> Signup and view all the answers

    Daptomycin is used to treat uncomplicated UTIs.

    <p>False</p> Signup and view all the answers

    Colistimethate can cause acute respiratory failure when administered orally.

    <p>False</p> Signup and view all the answers

    Telavancin is used to treat MRSA and other gram-positive infections.

    <p>True</p> Signup and view all the answers

    Before beginning antibiotic therapy, the patient's drug allergies and medical history should be assessed.

    <p>True</p> Signup and view all the answers

    Patients should be instructed to stop taking antibiotics if they feel better.

    <p>False</p> Signup and view all the answers

    Nursing implications for Sulfonamides include taking the medication with 2000 to 3000 ml of fluid per 24 hours.

    <p>True</p> Signup and view all the answers

    The most common adverse effects of antibiotics are headache, dizziness, and nausea.

    <p>False</p> Signup and view all the answers

    Study Notes

    Infections

    • Community-associated infections: acquired by individuals who have not been hospitalized or had a medical procedure within the past year.
    • Healthcare-associated infections: contracted in a hospital or institutional setting, not present or incubating at the time of admission, and occur more than 48 hours after admission.

    Prevention of Healthcare-Associated Infections

    • Handwashing: essential in preventing infections.
    • Antiseptics: inhibit the growth of microorganisms, applied exclusively to living tissue.
    • Static agents: inhibit the growth of microorganisms.
    • Disinfectants: kill microorganisms, used on nonliving objects.
    • Cidal agents: kill microorganisms.

    Antibiotics

    • Medications used to treat bacterial infections.
    • Superinfection: an infection that develops due to the treatment of a different infection, leading to the destruction of good bacteria.
    • Host factors: age, current health status, lifestyle choices, and religion affect antibiotic treatment.

    Sulfonamides

    • One of the first groups of antibiotics.
    • Often combined with another antibiotic.
    • Sulfamethoxazole combined with trimethoprim is known as Bactrim.
    • Not given in the first trimester of pregnancy.
    • Effective against both gram-positive and gram-negative bacteria.
    • Used to treat urinary tract infections (UTIs).
    • Adverse effects: blood system, integumentary system, GI system, and other effects.

    Beta-Lactum Antibiotics

    • Penicillins: natural, penicillinase-resistant, and amniopenicillins.
    • Cephalosporins: structurally and pharmacologically related to penicillin, broad-spectrum drugs.
    • Carbapenems: reserved for complicated body cavity and connective tissue infections.
    • Monobactums: used for moderately severe systemic infections and UTIs.

    Macrolides

    • Erythromycin, azithromycin, and clarithromycin.
    • Fidaxomicin: indicated only for the treatment of C. difficle-associated diarrhea.
    • Adverse effects: palpitations, jaundice, chest pain, hearing loss, and other effects.

    Tetracyclines

    • Demeclocycline, oxytetracycline, and tetracycline.
    • Causes discoloration of teeth in the fetus and throughout adulthood.
    • Delays growth in babies.
    • May retard fetal skeletal development if taken during pregnancy.
    • Adverse effects: vaginal candidiasis, gastric upset, enterocolitis, and maculopapular rash.

    Aminoglycosides

    • Poor oral absorption, no oral forms (except neomycin).
    • Very potent antibiotics with serious toxicities.
    • Bacterial, kills mostly gram-negative bacteria.
    • Can be used for pressure ulcers and deep wounds.
    • Adverse effects: nephrotoxicity, ototoxicity, and other effects.

    Quinolones

    • Also called fluoroquinolones, excellent oral absorption.
    • Absorption reduced by antacids.
    • Medications include: ciprofloxacin, norfloxacin, and others.
    • Indications: patients with complicated urinary tract, respiratory, bone and joint, GI, skin, and sexually transmitted infections.
    • Adverse effects: CNS, GI, cardiac, and other effects.

    Miscellaneous Antibiotics

    • Clindamycin: used for chronic bone infections, genitourinary infections, and other serious infections.
    • May cause pseudomembranous colitis.
    • Linezolid: used to treat vancomycin-resistant Enterococcus faecium (VREF).
    • May cause hypertension, serotonin syndrome, and reactions with tyramine-containing foods.
    • Metronidazole: used for intraabdominal and gynecologic infections.
    • Nitrofurantoin: primarily used for uncomplicated UTIs.
    • May cause fatal hepatotoxicity.

    Nursing Implications

    • Assess drug allergies, renal, liver, and cardiac function, and other lab studies before beginning therapy.
    • Obtain a thorough patient health history, including immune status.
    • Assess for conditions that may be contraindications to antibiotic use or that may indicate cautious use.
    • Assess for potential drug interactions.
    • Obtain cultures from appropriate sites before beginning antibiotic therapy.
    • Instruct patients to take antibiotics exactly as prescribed and for the length of time prescribed.
    • Assess for signs and symptoms of superinfection.
    • Monitor for therapeutic effects and adverse reactions.

    Infections

    • Community-associated infections: acquired by individuals who have not been hospitalized or had a medical procedure within the past year.
    • Healthcare-associated infections: contracted in a hospital or institutional setting, not present or incubating at the time of admission, and occur more than 48 hours after admission.

    Prevention of Healthcare-Associated Infections

    • Handwashing: essential in preventing infections.
    • Antiseptics: inhibit the growth of microorganisms, applied exclusively to living tissue.
    • Static agents: inhibit the growth of microorganisms.
    • Disinfectants: kill microorganisms, used on nonliving objects.
    • Cidal agents: kill microorganisms.

    Antibiotics

    • Medications used to treat bacterial infections.
    • Superinfection: an infection that develops due to the treatment of a different infection, leading to the destruction of good bacteria.
    • Host factors: age, current health status, lifestyle choices, and religion affect antibiotic treatment.

    Sulfonamides

    • One of the first groups of antibiotics.
    • Often combined with another antibiotic.
    • Sulfamethoxazole combined with trimethoprim is known as Bactrim.
    • Not given in the first trimester of pregnancy.
    • Effective against both gram-positive and gram-negative bacteria.
    • Used to treat urinary tract infections (UTIs).
    • Adverse effects: blood system, integumentary system, GI system, and other effects.

    Beta-Lactum Antibiotics

    • Penicillins: natural, penicillinase-resistant, and amniopenicillins.
    • Cephalosporins: structurally and pharmacologically related to penicillin, broad-spectrum drugs.
    • Carbapenems: reserved for complicated body cavity and connective tissue infections.
    • Monobactums: used for moderately severe systemic infections and UTIs.

    Macrolides

    • Erythromycin, azithromycin, and clarithromycin.
    • Fidaxomicin: indicated only for the treatment of C. difficle-associated diarrhea.
    • Adverse effects: palpitations, jaundice, chest pain, hearing loss, and other effects.

    Tetracyclines

    • Demeclocycline, oxytetracycline, and tetracycline.
    • Causes discoloration of teeth in the fetus and throughout adulthood.
    • Delays growth in babies.
    • May retard fetal skeletal development if taken during pregnancy.
    • Adverse effects: vaginal candidiasis, gastric upset, enterocolitis, and maculopapular rash.

    Aminoglycosides

    • Poor oral absorption, no oral forms (except neomycin).
    • Very potent antibiotics with serious toxicities.
    • Bacterial, kills mostly gram-negative bacteria.
    • Can be used for pressure ulcers and deep wounds.
    • Adverse effects: nephrotoxicity, ototoxicity, and other effects.

    Quinolones

    • Also called fluoroquinolones, excellent oral absorption.
    • Absorption reduced by antacids.
    • Medications include: ciprofloxacin, norfloxacin, and others.
    • Indications: patients with complicated urinary tract, respiratory, bone and joint, GI, skin, and sexually transmitted infections.
    • Adverse effects: CNS, GI, cardiac, and other effects.

    Miscellaneous Antibiotics

    • Clindamycin: used for chronic bone infections, genitourinary infections, and other serious infections.
    • May cause pseudomembranous colitis.
    • Linezolid: used to treat vancomycin-resistant Enterococcus faecium (VREF).
    • May cause hypertension, serotonin syndrome, and reactions with tyramine-containing foods.
    • Metronidazole: used for intraabdominal and gynecologic infections.
    • Nitrofurantoin: primarily used for uncomplicated UTIs.
    • May cause fatal hepatotoxicity.

    Nursing Implications

    • Assess drug allergies, renal, liver, and cardiac function, and other lab studies before beginning therapy.
    • Obtain a thorough patient health history, including immune status.
    • Assess for conditions that may be contraindications to antibiotic use or that may indicate cautious use.
    • Assess for potential drug interactions.
    • Obtain cultures from appropriate sites before beginning antibiotic therapy.
    • Instruct patients to take antibiotics exactly as prescribed and for the length of time prescribed.
    • Assess for signs and symptoms of superinfection.
    • Monitor for therapeutic effects and adverse reactions.

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    Learn about the different types of infections, including community-associated and healthcare-associated infections, and the importance of handwashing and antiseptics in preventing them.

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