314 exam 2 Flashcards
1
Q
three primary factors of infection transmission
A
- reservoir
- susceptibility
- route of transmission
2
Q
noticing is _____ and prevention is ______
A
noticing is assessment
prevention is asepsis
3
Q
direct contact means _____
A
physical contact is needed to spread such as person to person
4
Q
indirect contact means ____
A
passing infection by passive methods such as unclean hands, contaminated instruments and devices, and unclean scrubs.
5
Q
indirect transmission means ____
A
contact with infectious droplets such as sneezing
6
Q
negative pressure room means that ____
A
air cannot leave the room (isolated enviroment)
7
Q
positive pressure room means that ____
A
air pressure it set to make air leave the room rapidly thus creating a sterile room environement (opposite of negative pressure rooms)
8
Q
negative pressure rooms are used in patients for
A
keeping isolation precautions in the room. keeping highly transmissible infectious air contained within the specific room.
9
Q
positive air pressure rooms are used in patients for
A
removing any airborne infection from the room for a patient to be placed on immunocompromised precautions
10
Q
airborne transmission means that _____
A
infectious particles remain in the air for prolonged periods of time.
11
Q
tuberculosis and chickenpox (varicella-zoster) are examples of (precautions)
A
airborne infections
12
Q
standard precautions refers to ___
A
the use of personal protective equipment - masks, gloves, goggles, gown etc.
13
Q
biofilm is
A
slime coating that accumulates on medical devices such as indwelling catheters and bladder scanners that serve as a reservoir for infection to live.
14
Q
best way to prevent antibiotic resistance in patients
A
proper teaching in completion of the antibiotic treatment
15
Q
MRSA is normal/harmless when ___
A
on the skin
16
Q
MRSA becomes harmful when ___
A
it enters the body
17
Q
most common way that MRSA is spread
A
direct contact
18
Q
enterococcus bacteria live ____
A
normally in the digestive tract
19
Q
enterococcus bacteria become a problem when _____
A
they escape the digestive tract where they are supposed to live thus causing an infection
20
Q
The primary issue with VRE (vancomycin-resistant enterococcus) is that
A
it can live on surfaces such as door handles and toilet seats for weeks.
21
Q
how does VRE (vancomycin-resistant enterococcus) spread
A
through indirect contact (ie. door handles, toilet seats etc.)
22
Q
CRE (Carbepenem-Resistant Enterobactericeae) infections are a result of
A
normal enterobactericeae escaping the digestive tract and causing infection
23
Q
examples of enterobactericeae which can cause infection
A
e coli
klebsiella
(both located within the GI tract)
24
Q
_______ may be enforced by the court to ensure that a patient with a communicable disease finishes treatment
A
direct observational therapy
25
complete blood count with differential shows
all blood counts including all white blood cell types and their values
26
shift to the left means (WBC's)
the body is producing more immature neutrophils to replace the WBC's that were lost in battle
27
(ESR) erythrocyte sedimentation rate shows
level of inflammation that is occurring somewhere in the body (specific location not systemic)
28
a radiography is the same thing as an
X ray
29
infection of the heart valves is detected by
ultrasound
30
infection deterioration of bone structures and or consolidation in soft tissues is detected with
ultrasound
31
patients who are immunocompromised may not display a _______ during infection
fever
32
giving acetaminophen will _____ infections
mask signs of infection and how the body is fighting it
33
three most important things to consider when treating infections
1. client comfort
2. correct and most effective antibiotic
3. desired outcome
34
if someone is cold (shivering) their _____ is higher due to fever due to infection
body temperature is higher than room temperature (so they think the room is cold) so they shake (shiver) to warm up
35
external cooling mechanisms such as cooling blankets go _____ not ____
under the patient not on top
36
father of penicillin
Alexander Fleming
37
five antibiotic mechanisms of action
1. inhibition of bacterial cell-wall synthesis
2. alteration of membrane permeability
3.inhibition of the synthesis of RNA and DNA
4. inhibition of protein synthesis
5. interference with metabolism within the cell
38
Amoxicillin highest dose not to be exceeded per day
1750 mg / day
39
Amoxicillin is potentially ______ toxic
renal toxic in long term use and at high dosages
40
Main drug contraindication with Amoxicillin
aspirin will vastly increase bleeding with concurrent use of anticoagulants
41
Using _____ in combination with amoxicillin may increase the risk of _______
anticoagulants or acetylsalicylic acid may significantly increase risk of bleeding
42
Very high doses of penicillin derivatives can cause ______ and result in ______
thrombocytopenia and result in bleeding
43
ceftriaxone is a _____ class of antibiotic
cephalosporin
44
ceftriaxone is commonly given as prophylaxis when?
before surgical procedures to prevent infections during surgery
45
before giving cephalosporins such as ceftriaxone, ________ should be assessed.
kidney function should be assessed
46
______ are contraindicated with ceftriaxone
loop diuretics
47
loop diuretics given with ceftriaxone and anticoagulants are at high risk for causing _______
bleeding
48
a uniquly reported side effect of ceftriaxone is that it can cause ______
alterations in taste
49
ceftriaxone adverse reactions
steven johnson syndrome
agranulocytosis
biliary obstruction - leads to jaundice
50
a biliary obstruction is where
the bile duct system is blocked leading to impaired bile flow from the liver into the intestinal tract causing jaundice
51
three main macrolide antibiotics
Azithromycin, erythromycin and clarithromycin
52
macrolides - Azithromycin, erythromycin and clarithromycin are highly toxic to the ______
liver and must be assessed for liver functioning prior
53
avoid taking Azithromycin, erythromycin and clarithromycin with _______
digoxin
54
Azithromycin, erythromycin and clarithromycin vastly increase the effects of which three drugs
digoxin
warfarin
cyclosporine
55
cyclosporine is a _______ used for _____
immunosuppressive drug used to treat organ rejection in post-transplant patients
56
side effects of mycin's
blurred vision
ocular pain
tinnitus
photosynsitivity
57
macrolides (mycin's) adverse reactions
hepatotoxicity
steven johnson
thrombocytopenia
bronchospasm
58
most important patient teaching regarding macrolides (mycin's)
report onset of loose stools or diarrhea
59
erythromycin can lead to sudden death if taken with
verapamil
diltiazem
fluconazole
60
azithromycin can remain active for up to _____ hours
68 hours
61
clarithromycin is given _____ per day
once per day
62
staph infections are ______ infections.
gram +
63
the min Lacosamide drug of focus is
clindamycin
64
drug of choice used in staph gram + infections
clindamycin
65
bacteriostatic definiton
the agent prevents the growth of bacteria
66
bactericidal definition
the agent directly kills bacteria
67
clindamycin is consitered ______ in principle (effect on bacteria)
bacteriostatic
68
aminophylline is a _____ agent
bronchodilator
69
side effects of clinidamycin
GI irritation
rash
anaphylactic shock
70
Do not give ______ with clindamycin
aminophylline
phenytoin
ampicillin
71
glycopeptide antibiotic of focus _____
vancomycin
72
vancomycin alone is not effective for treating _______ infections
enterococci
73
Quinupristin / Dalfopristin
Brand name: Synercid is combined with ______ to treat enterococci
vancomycin
74
VRE vancomycin resistant enterococci left untreated can lead to
endocarditis
75
endocarditis is
inflammation of the heart valves and inner lining of the heart ventricles
76
________ have to be monitored with vancomycin
peaks and troughs
77
strict infusion time for vancomycin
60 to 90 minutes
78
infusion too fast of vancomycin can cause ______
red man syndrome
steven johnson
renal failure
79
vancomycin is both highly _____ and _____
nephrotoxic and ototoxic
80
_______ will mask vancomycin toxicity
dimenhydrinate (dramamine)
81
doxycycline is not effective against _____
staph aureus
82
common uses of doxycyline
control of acne
gingivitis
STD's
UTI's
83
doxycycline should be taken ______
with meals
84
doxycycline and tetracyclines should be highly avoided during ______
pregnancy
85
older generations of tetracyclines should be taken _______ before meals or ______ after
1 hour before meals or 2 hours after
86
doxycycline is considered to be ______ (bacterial effects)
bacteriostatic
87
side effects of doxycycline
GI pain
tooth and nail discoloration
blurred vision
88
doxycycline is contraindicated in children because
it stains teeth and nails
89
aminoglycoside of focus
gentamicin
90
primary use of gentamicin
gram - bacteria
91
gentamicin can not be used in patients with ______
kidney disease
hearing impairment
hypokalemia
92
main side effect of gentamicin
tinnitus
93
mixing gentamycin with vancomycin and penicillin results in
ototoxicity
94
an adverse event specific to gentamicin is that it can cause _____ (3 things)
hypokalemia
hypomagnesemia
hyponatremia
thus leading to hyperbilirubinemia which is seen as jaundice
95
fluoroquinolones of focus (two)
ciprofloxacin / levofloxacin
96
cipro/levo main contraindication
renal disease
97
two specific adverse reactions key to cipro / levo
GI bleeding
tendon rupture
98
cipro and levo can increase the effects of
oral hypoglycemic drugs such as metformin
99
important intervention for cipro and levo monitoring
assessing for hypoglycemia because of the enhanced effects of hypoglycemics
100
gentamicin has a high risk for ____ (toxicities)
kidney toxicity
ototoxicity
101
gentamicin has a high chance of lowering ______
potassium
102
unique adverse effect of cipro / levoflox
tendon weakening and rupture
103
common effect of multiple antibiotic therapy
fungal and yeast infections due to destruction of the mucousal membranes
104
sulfa antibiotics
trimethrprim - sulfamethoxazole
105
allergies to sulfa are common
allergies to sulfa are common
106
primary concern with sulfa
renal and liver toxic
107
unique adverse effects to sulfa (two)
glossitis (swelling of the tongue)
rhabdomyolysis
108
take sulfa or bactrum ______ meals
1 hour before or 2 hours after meals
109
antifungal - metronidazole two primary uses
used for C diff and trichomoniasis (STD)
110
two side effects (expected) of mentronidazole
dark urine
metallic tasts
111
extreemly important to avoid _____ when taking metronidazole
alcohol intake
112
tuberdifine is a
high power anti fungal that is extremely liver toxic.
113
fluconazole main contraindication
high prevalence of allergies
114
fluconazole enhances the effects of four drugs
warfarin
oral hypoglycemics
dilantin
clopidogrel
115
with fluconazole, monitor which lab
liver enzymes
116
nystatin is a
antifungal which only affects fungal spores
117
nystatin is used to ______
prevent thrush
118
thrush is a _____
oral yeast infection
119
how to take nystatin
swish and swallow
120
amphotericin B is a
highly toxic super strong antifungal used for systemic candidiasis
121
last line of antifungal is ______
amphotericin B
122
amphotericin B is highly toxic on the
bone marrow
liver
kidneys
123
amphotericin B lowers (electrolytes)
hypokalemia
hypomagnesemia
124
hepatoxicity when on HIV medication results in rise of blood concentrations of ______
cholesterol and triglycerides
125
seroconversion of HIV to AIDS takes place when
cd4 t cell count is 200 or less
126
antiviral therapy responds well if the CD4 count is
higher than 200
127
HIV symptoms can be mistaken as a ______
cold or flu
128
non risk factor patients should be screened at least ______ for HIV in the lifetime
once
129
stage 0 HIV is marked by
positive HIV test result but no other symptoms
cd4 cells in normal range
130
stage 1 HIV is marked by
CD4 greater than 500
131
stage 2 HIV is marked by
CD4 between 200 and 499
132
stage 3 HIV is marked by
CD4 count less than 200
133
a patient with very low CD4 count will not respond to what
TB skin tests
134
two priority interventions for patients in stage 2 HIV
Initiate antiretroviral therapy (ART).
Monitor and manage opportunistic infections
135
Didanosine requires dosage adjustments for those with ______ impairments
kidney
136
for most HIV meds ______ occurs and then subsides after two weeks
GI and abdominal pain
137
multiple nucleotide reverse transcriptase inhibitors used at once can result in
lactic acidosis
138
-ine is a
nucleotide reverse transcriptase inhibitor
139
NON nucleotide reverse transcriptase inhibitor of focus
efavirenz
140
side effects of non nucleotide reverse transeiptase inhibitors (efavirenz)
odd dreams
liver failure
hyperlipidemia
141
protease inhibitor of focus
atazanavir
142
adverse effect unique to protease inhibitors (atanzanavir)
cardiac arrhythmias
143
regular side effect of protease inhibitors (atanzanavir)
elevation of cholesterol and triglycerides
144
CCR5 antagonist of focus
maraviroc
145
adverse effect of CCR5 antagonist (maraviroc)
cardiac arrhythmias
146
expected side effects of CCR5 inhibitors
coughing
pyrexia
rash
upper respiratory infection
147
Integrase inhibitor of focus
raltegravir
148
first line treatment med for HIV
integrase inhibitor (raltegravir)
149
integrase inhibitor (raltegravir) can be taken with
food or without food doesnt matter
150
adverse effect of integrase inhibitor (raltegravir)
Steven johnson
pyrexia
high cholesterol level
151
IRIS stands for
immune reconstitution inflammatory syndrome
152
immediate treatment for IRIS (immune reconstitution inflammatory syndrome)
corticosteroids
153
mainline treatment for late stage HIV pain
gabapentins
154
for nurses potentially exposed to HIV ____
post exposure prophylaxis for up to 4 weeks is needed
