ANTI INFECTIVE

Question 1

Antibiotics: Common AE

Answer 1

1. Gi effects
2. Skin effects
3. Hypersensitivity rxn (true allergy or expected AE)
4. Superinfections/ Secondary infection. Cdiff, yeast infection

Question 2

Toxicities: How to prevent

Answer 2

More on IV antibiotics
1. AKI – prevent by hydration so teach patient

2. Neurotoxicity- no preventative measure
3. Liver toxicity –
4. Nephrotoxicity – urine output (vancomycin )

Question 3

Lifespan

Answer 3

Adults:
1. female on birth control pill use additional protection against pregnancy because birth control becomes less effective. As a nurse make sure you will do your assessment.
Pregnancy category c

2. older adult ; risk for toxicity ( reduce liver , kidney function)

Question 4

Nursing Administration
PRIOR:

Answer 4

1. assessment and health hx
2. obtain cultures indicated
3. note s/s of current infection
4. monitor pt/ inr because antibiotics can have

Question 5

Nursing Administration
WHEN administering

Answer 5

Oral
1. oes / full glass water 1 hr before meals or 2-3 hrs. after meals
2. never take with fruit juice, soft drinks or milk

IV
1. observe for inflammation of veins (phlebitis)
2. check rate infusion (ivp)
3. check compatibility with meds / iv fluids
4. vancomycin is preferred on central line.

Question 6

Nursing Administration
WHEN administering

Answer 6

Oral
1. oes / full glass water 1 hr before meals or 2-3 hrs. after meals
2. never take with fruit juice, soft drinks or milk

IV
1. observe for inflammation of veins (phlebitis)
2. check rate infusion (ivp)
3. check compatibility with meds / iv fluids
4. vancomycin is preferred on central line.

Question 7

Throughout administration

Answer 7

1. monitor /report therapeutic effects, adverse effects
2. lab values cbc ,kidney functions, lft
3. peak or through
4. ensure hydration to reduce aki

Question 8

Throughout administration

Answer 8

1. monitor /report therapeutic effects, adverse effects
2. lab values cbc ,kidney functions, lft
3. peak or through
4. ensure hydration to reduce aki

Question 9

Patient education.

Answer 9

1. TAD
2. Females use another contraceptive
3. Drink 3 l h2o
4. Report ae to hcp.

Question 10

Patient education.

Answer 10

1. TAD
2. Females use another contraceptive
3. Drink 3 l h2o
4. Report ae to hcp.

Question 11

ANTIBIOTICS DRUGS

GENTAMICIN
1. AE: tinnitus, hearing loss, systemic routes high rf toxicities
2. BBW: nephrotoxicity, neurotoxicity
3. NURSING: draw peak (after 1 hr.)

Question 12

ANTIBIOTICS DRUGS

GENTAMICIN
1. AE: tinnitus, hearing loss, systemic routes high rf toxicities
2. BBW: nephrotoxicity, neurotoxicity
3. NURSING: draw peak (after 1 hr.)

Question 13

ERTRAPENEM
1. AE: systemic routes high rf toxicities
2. NURSING:

Question 14

CIPROFLOXACIN
1. AE:
a. Photosensitivity (sun sensitive)
b. Tendon rupture possible with corticosteroid
c. Dysrhythmias with IV route need telemetry
2. NURSING:
a. telemetry if indicated
b. educate wear sunscreen

Question 15

ERYTHROMYCIN
1. AE: IV route high risk for toxicities
2. NURSING

Question 16

AMOXICILLIN
1. CONTRAINDICATION:
a. sensitivity to cephalosporin
b. renal disease
c. pregnancy category b
2. DRUG-DRUG INT: decrease effectiveness of oral contraceptives , increase anticoagulation effect of warfarin
3. AE:
4. NURSING:

Question 17

CEFAZOLIN
1. CONTRAINDICATION:
a. allergy to penicillin
b. pregnancy category b
2. DRUG-FOOD: alcohol
3. AE:
4. NURSING:

Question 18

CEFAZOLIN
1. CONTRAINDICATION:
a. allergy to penicillin
b. pregnancy category b
2. DRUG-FOOD: alcohol
3. AE:
4. NURSING:

Question 19

SMZ

Question 20

DOXYCYCLINE
1. AE: teeth discoloration, photosensitivity
2. CONTRAINDICATION: pregnancy
3. DRUG-DRUG: decreases effectiveness of oral contraceptives
4. NURSING: use sunscreen

Question 21

DOXYCYCLINE
1. AE: teeth discoloration, photosensitivity
2. CONTRAINDICATION: pregnancy
3. DRUG-DRUG: decreases effectiveness of oral contraceptives
4. NURSING: use sunscreen

Question 22

VANCOMYCIN

1. AE:
2. NURSING: assessment priority ( urine output)

**Through draw( before ) to make sure patient is getting enough medications and to avoid toxicities
**Note about superinfection via iv vancomycin cdiff , cdiff has to be oral vancomycin because it gets to the gi tract

**Administer over at least 1 hr to reduce redman syndrome

Question 23

METRONIDAZOLE (antibiotic/ antiprotozoal)

1. CONTRAINDICATION:
   a. Renal / liver dysfunction
   b. Pg / lactation
2. DRUG-DRUG: anticoagulants (warfarin)
3. AE:
   a. CNS effects
   b. Metallic taste (that’s normal)
   c. Severe n/v with alcohol intake
4. NURSING: don’t take alcohol

Question 24

METRONIDAZOLE (antibiotic/ antiprotozoal)

1. CONTRAINDICATION:
   a. Renal / liver dysfunction
   b. Pg / lactation
2. DRUG-DRUG: anticoagulants (warfarin)
3. AE:
   a. CNS effects
   b. Metallic taste (that’s normal)
   c. Severe n/v with alcohol intake
4. NURSING: don’t take alcohol

Question 25

TB Treatment (antibiotic/ antimycobacterial)

1. AE (major)
   a. GI effects nvd ( orange tint body fluids
   b. Neuropathy
   c. Bone marrow suppression
   d. Liver toxicity
2. DRUG- DRUG
3. NURSING:
   a. Monitor ae
   b. Monitor labs
   c. Educate TAD
   d. Do not stop meds
   e. Treatment 6 months to 2 years

Question 26

TB Treatment (antibiotic/ antimycobacterial)

1. AE (major)
   a. GI effects nvd ( orange tint body fluids
   b. Neuropathy
   c. Bone marrow suppression
   d. Liver toxicity
2. DRUG- DRUG
3. NURSING:
   a. Monitor ae
   b. Monitor labs
   c. Educate TAD
   d. Do not stop meds
   e. Treatment 6 months to 2 years

Question 27

ANTIVIRAL
Need to know specific indications, what virus

OSELTAMIVIR (tamiflu)
1. INDICATIONS: treatment or prophylaxis to decrease the s/s of flu
2. CONTRAINDICATIONS: pg / bf
3. AE: gi effects nvd
4. NURSING:
a. Treatment should be initiated within 48 hrs of symptoms
b. Do not administer 46 hrs before flu vaccine or 2 weeks after
c. May take with food to decrease GI intolerance

Question 28

ANTIVIRAL
Need to know specific indications, what virus

OSELTAMIVIR (tamiflu)
1. INDICATIONS: treatment or prophylaxis to decrease the s/s of flu
2. CONTRAINDICATIONS: pg / bf
3. AE: gi effects nvd
4. NURSING:
a. Treatment should be initiated within 48 hrs of symptoms
b. Do not administer 46 hrs before flu vaccine or 2 weeks after
c. May take with food to decrease GI intolerance

Question 29

ACYCLOVIRAL
1. INDICATIONS: herpes , variceralla zoster
2. ROUTES : oral ,topical ,iv( short duration)
3. AE:
a. Oral; malaise headache , nvd
b. IV: rf toxic
4. NURSING:
a. oral: amin around the clock (atc) with food; use gloves when applying
b. iv ; infuse over 1hr to decrease renal damage ;ensure patient hydrated

Question 30

ANTI-RETROVIRAL
1. AE:
a. Gi effects
b. Cns effects
c. Flu like syndrome
d. Rf toxicity
2. NURSINF:
a. TAD
b. Do not skip dose
c. Take at the same time everyday
d. Refill meds before they run out
e. Report: rashes, severe di/vo, drowsiness . dizziness , difficulty breathing (sob)
f. Keep schedule lab and hcp appts

Question 31

ANTI-FUNGAL
NYSTATIN (topical) given about 6 weeks.
1. AE:
a. Topical: contact dermatitis
b. Oral: nvd
2. NURSING
a. Topical: apply to affected area using gloves
b. Oral: direct patients to swish 2 mins , and swallow ,
c. Oral: children – swab

Question 32

ANTI-FUNGAL
NYSTATIN (topical) given about 6 weeks.
1. AE:
a. Topical: contact dermatitis
b. Oral: nvd
2. NURSING
a. Topical: apply to affected area using gloves
b. Oral: direct patients to swish 2 mins , and swallow ,
c. Oral: children – swab

Question 33

FLUCONAZOLE sometimes pt needs this meds long term so they need liver check / labs monitor like if they are in 6 mos treatment they need to have 3 month check

1. AE: nvd , long duration , liver toxicity
2. CONTRAINDICATIONS:
   a. liver disease
   b. pg