Antibacterial (Test 4)

Question 1

Peak (When is it drawn? What is it?)

Answer 1

Drawn after drug is administered. Highest level of drug in body

Question 2

Tough (When is it drawn? What is it ?)

Answer 2

Drawn immediately before next dose. Lowest Level of drug in body

Question 3

Penicillin & Cephalosporin (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 3

Beta Lactam ring interferes with cell-wall synthesis by binding proteins
Bacteriostatic & Bactericidal
Overuse leads to resistance

Indications: staph infections,
E. Ecoli, Shigella, Salmonella
Strep
Pseudonomas

Implications: Check allergy history and for reaction

• Check liver enzymes and kidney function
• Assess for superinfection

Education: take entire med as ordered
Wear bracelet if allergic
Increase fluids
TAKE WITH FOOD

Question 4

Macrolides (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 4

Inhibit bacterial protein synthesis
Often used for people allergic to penicillin
Bacteriostatic-low dose
Bacteriocidal-high dose
ORALLY OR IV

Indications: Mycoplasmia pneumonia (Biaxin)
Respiratory infections
STIs
Uncomplicated skin infections

Educations: Take with juices, NO acidic foods to decrease GI irritation
Monitor liver function tests

Question 5

Tetracyclines (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 5

Inhibit bacterial protein synthesis
Bacteriostatic ONLY

Indications: Mycoplasma pneumonia
H. Pylori
Acne Vulgaris

Implications: Assess liver and kidney function
Administer 1-2 hours before or after meals

Education: Store away from light and extreme heat
Do not take out of date medication
Do not take during pregnancy
Do not give to children less than 8 years old
Wear protective clothing or sunscreen
Use additional contraceptions if taking oral contraceptives
Should be taken on empty stomach, acidic things avoid
Should not be administered with antacids

Question 6

Glycopeptides (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 6

Inhibit cell wall synthesis
Nephrotoxic and Ototoxicity
Trouble hearing

Indications: MRSA (drug-resistant staph aureus)
C diff (clostridium difficile)

Implications: Closely monitor patients
Dilute and administer over at least 60 minutes via a large vein or central line
Assess for red man syndrome

Question 7

Aminoglycosides (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 7

Inhibit protein synthesis
Oto and nephrotoxic
Bacterial resistance
IM, IV, 
NOT PO, only given to decrease bacteria in bowel

Indications: Streptomyocin
TB
Pseudomonas
E. Coli
Tularemia 
Bubonic pneumonic plague

Implications: Monitor BUN and Serum Creatinine prior and during administration
Monitor urine output
Monitor for hearing loss
Monitor peaks and troughs

Education: Encourage fluid intake
Report hearing loss, dizziness
Protect skin form sun

Question 8

Fluoroquinolones (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 8

Interferes with bacterial DNA synthesis

Indications:
Strep
H. Influenza
Pseudonomas, salmonella, shigella
UTI
bone joints, bronchitis
pneumonia, gastroenteritis
gonorrhea

Implications: Monitor Renal Function, urine output
Dilute as indicated for IV administration
Monitor Blood Glucose levels
Can increase action of theophyline and caffeine

Education:-Drink 6-8 glasses of water daily

• Take 2 hours before or after antacids and iron
• Caution operating machinery-dizziness
• Can cause tendonitis and tendon problems

Question 9

Sulfonomides (MOA, Assessments, Indications, Nursing Care, Teaching)

Answer 9

Inhibit bacterial synthesis of folic acid
Moderate to highly protein bound

Indications :E. Coli, Chlamydia, Toxoplasma

Implications: Check allergies, if allergic to one sulf, allergic to all
Asses renal function: BUN, creatinine, and urine output
Administer with full glass of water

Education:Drink several quarts of water daily to prevent crystals in urine

• Avoid Sulfonamides in last trimester
• Do not take with antacids
• Use sunburn protection
• If allergic to one sulfa- allergic to all

Question 10

Azithromycin (Zithromax) classification

Answer 10

Macrolide

Question 11

Doxycycline (Vibramycin) classification

Answer 11

Tetracycline

Question 12

Vancomycin (Vancocin) classification

Answer 12

Glycopeptide

Question 13

Gentamycin (Garamycin) classification

Answer 13

Aminoglycoside

Question 14

Trimethoprim-sulfamethoxazole (Bactrim or Septra) classification

Answer 14

Sulfonomide

Question 15

Levofloxacin (Levaquin) classification

Answer 15

Fluoroquinolone

Question 16

Amoxicillin (Amoxil) classification

Answer 16

Penicillin & Cephalasporin

Question 17

What is informed consent called and explain it?

Answer 17

Operative permit
Legal responsibility of physician
Nurse may get patient to sign, act as legal witness to their signature

Question 18

Patient/Family Education for Pre-op

Answer 18

Reason for tests
Pre-op routines: exercises, ankle pumps
Medications: home and pre-op
Dietary changes: no solid food 6-12 hours and NPO 4-8 hours 
Skin or bowel preparation 
Time/length of surgery 
Time in PACU
Where family waits and be contacted
Recovery process
Pain Control
Discharge needs 
Cultural sensitivity

Question 19

What is a time out?

Answer 19

Entire surgical team stops to confirm patient, procedure, and site

Question 20

What is ICS?

Answer 20

Incentive spirometer (Medical device used to help functioning of lungs)