50 Questions
Which of the following medications is commonly prescribed for severe urinary tract infections?
Ciprofloxacin
What is a common adverse effect of aminoglycoside antibiotics?
Ototoxicity
Which of the following quinolones can cause a prolonged QT interval?
Moxifloxacin
What is the minimum inhibitory concentration (MIC) used to monitor?
Drug levels
Which of the following antibiotics can cause pseudomembranous colitis?
Clindamycin
What is the black box warning for quinolones?
Increased risk of tendonitis and tendon rupture
Which of the following antibiotics is used to treat vancomycin-resistant Enterococcus faecium?
Linezolid
What is a common indication for fluoroquinolones?
All of the above
Which of the following antibiotics can cause serotonin syndrome when taken with selective serotonin reuptake inhibitors (SSRIs)?
Linezolid
What is Plazomicin (Zemdi) used to treat?
Complicated urinary tract infections
What is the primary use of Nitrofurantoin?
Treatment of uncomplicated UTIs
What is a potential adverse effect of Vancomycin?
Ototoxicity and nephrotoxicity
What is essential to obtain before beginning antibiotic therapy?
Cultures from appropriate sites
Why is it important to check the name of the medication carefully?
Because many drugs sound alike or have similar spellings
What is a nursing implication for Sulfonamides?
Taking with 2000-3000 ml of fluid/24 hours
What is a common adverse effect of antibiotics?
Nausea, vomiting, and diarrhea
What should patients be instructed to do when taking antibiotics?
Take the medication exactly as prescribed and for the length of time prescribed
What is a nursing implication for Tetracyclines?
Avoiding milk products, iron preparations, antacids, and other dairy products
What is important to assess before beginning antibiotic therapy?
Drug allergies, renal, liver, and cardiac function, and other laboratory study results
What should be monitored for when administering Telavancin?
Renal toxicity, infusion-related reactions, and QT prolongation
What is the definition of a community-associated infection?
An infection that is acquired by a person who has not been hospitalized or had a medical procedure within the past year
What is the primary difference between healthcare-associated infections and community-associated infections?
The location where the infection is acquired
What is the main contraindication for cephalosporins?
History of throat swelling or hives from penicillin
What is the main characteristic of methicillin-resistant Staphylococcus aureus (MRSA)?
It is a type of Gram-positive bacteria
Which class of antibiotics is reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients?
Carbapenems
What is the main adverse effect of tetracyclines during pregnancy?
Retardation of fetal skeletal development
What is the primary purpose of antiseptics?
To inhibit the growth of microorganisms
What is the term for an infection that develops because of trying to treat a different infection, and all good bacteria have been killed?
Superinfection
Which antibiotic is indicated only for the treatment of C.difficile-associated diarrhea?
Fidaxomicin
What is the main interaction between cephalosporins and other medications?
All of the above
What is the term for the class of antibiotics that includes Sulfonamides?
Sulfonamides are not a class of antibiotics
What is the primary indication for Sulfonamides?
Effective against both gram-positive and gram-negative bacteria
Which generation of cephalosporins is used to treat uncomplicated and complicated UTIs?
Fourth generation
What is the main adverse effect of macrolides?
GI effects
What is the primary adverse effect of Sulfonamides on the blood system?
Hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia
What is the main interaction between aminoglycosides and other medications?
No oral forms
Which of the following is a Penicillinase-resistant drug?
Nafcillin
What is the primary indication for Penicillin?
Prevention and treatment of infections caused by Gram-positive bacteria
Which antibiotic is used to treat bone, joint, skin, and soft tissue infections?
Imipenem/Cilastatin
What is the main patient education instruction for taking tetracyclines?
All of the above
Nitrofurantoin is primarily used for treating complicated UTIs caused by E. coli bacteria.
False
Quinupristin-dalfopristin is used to treat MRSA and other gram-positive infections.
True
Vancomycin may cause hepatotoxicity.
False
Daptomycin is used to treat uncomplicated UTIs.
False
Colistimethate can cause acute respiratory failure when administered orally.
False
Telavancin is used to treat MRSA and other gram-positive infections.
True
Before beginning antibiotic therapy, the patient's drug allergies and medical history should be assessed.
True
Patients should be instructed to stop taking antibiotics if they feel better.
False
Nursing implications for Sulfonamides include taking the medication with 2000 to 3000 ml of fluid per 24 hours.
True
The most common adverse effects of antibiotics are headache, dizziness, and nausea.
False
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.
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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