Antibiotic Drugs Flashcards
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
a. Tetracyclines
b. Sulfonamides
c. Cephalosporins
d. Quinolones
ANS: C
Allergy to penicillin may also result in hypersensitivity to cephalosporins. Patients reporting penicillin allergy need to describe their prior allergic reaction. It is very important to document the type of reaction. The other options are incorrect.
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?
a. ―Avoid direct sunlight and tanning beds while on this medication.‖
b. ―Milk and cheese products result in increased levels of tetracycline.‖
c. ―Antacids taken with the medication help to reduce gastrointestinal distress.‖
d. ―Take the medication until you are feeling better.‖
ANS: A
Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for several days after therapy. Milk and cheese products result in decreased levels of tetracycline when the two are taken together. Antacids also interfere with absorption and should not be taken with tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if they feel that they are no longer ill.
When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin. What possible effect may occur as the result of an interaction between these drugs?
a. The penicillin will cause an enhanced anticoagulant effect of the warfarin.
b. The penicillin will cause the anticoagulant effect of the warfarin to decrease.
c. The warfarin will reduce the anti-infective action of the penicillin.
d. The warfarin will increase the effectiveness of the penicillin.
ANS: A
Administering penicillin reduces the vitamin K in the gut (intestines); therefore, enhanced anticoagulant effect of warfarin may occur. The other options are incorrect.
A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling ―anxious‖ and is having trouble breathing. What will the nurse do first?
a. Notify the prescriber.
b. Take the patient‘s vital signs.
c. Stop the antibiotic infusion.
d. Check for allergies.
ANS: C
Hypersensitivity reactions are characterized by wheezing; shortness of breath; swelling of the face, tongue, or hands; itching; or rash. The nurse should immediately stop the antibiotic infusion, have someone notify the prescriber, and stay with the patient to monitor the patient‘s vital signs and condition. Checking for allergies should have been done before the infusion.
A patient is admitted with a fever of 102.8°F (39.3°C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence?
a. Blood culture, antibiotic dose, urine culture
b. Urine culture, antibiotic dose, blood culture
c. Antibiotic dose, blood and urine cultures
d. Blood and urine cultures, antibiotic dose
ANS: D
All culture specimens should be obtained before initiating antibiotic drug therapy; otherwise, the presence of antibiotics in the tissues may result in misleading culture and sensitivity results. The other responses are incorrect.
A patient tells the nurse that he is having nausea and decreased appetite during drug therapy with a tetracycline antibiotic. Which statement is the nurse‘s best advice to the patient?
a. ―Take it with cheese and crackers or yogurt.‖
b. ―Take each dose with a glass of milk.‖
c. ―Take an antacid with each dose as needed.‖
d. ―Drink a full glass of water with each dose.‖
ANS: D
Oral doses should be given with at least 8 ounces of fluids and food to minimize gastrointestinal upset. Antacids and dairy products will bind with the tetracycline and make it inactive.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101°F (38.3°C). Based on these findings, which conclusion will the nurse draw?
a. The patient‘s original infection has not responded to the antibiotic therapy.
b. The patient is showing typical adverse effects of antibiotic therapy.
c. The patient needs to be tested for Clostridium difficile infection.
d. The patient will need to take a different antibiotic.
ANS: C
Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a serious superinfection when it causes antibiotic-associated colitis, also known as pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever. Whenever a patient who was previously treated with antibiotics develops watery diarrhea, the patient needs to be tested for C. difficile infection. If the results are positive, the patient will need to be treated for this serious superinfection.
The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
a. Increased red blood cell count
b. Increased hemoglobin level
c. Decreased white blood cell count
d. Decreased platelet count
ANS: C
Decreased white blood cell counts are an indication of reduction of infection and are a therapeutic effect of antibiotic therapy. The other options are incorrect.
The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?
a. First-generation
b. Second-generation
c. Third-generation
d. Fourth-generation
ANS: A
First-generation cephalosporins provide excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria.
A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?
a. Empiric
b. Prophylactic
c. Definitive
d. Resistance
ANS: B
Prophylactic antibiotic therapy is used to prevent infection. Empiric therapy involves selecting the antibiotic that can best kill the microorganisms known to be the most common causes of an infection. Definitive therapy occurs once the culture and sensitivity results are known. Resistance is not a type of antibiotic therapy.
A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?
a. Macrolides
b. Carbapenems
c. Sulfonamides
d. Tetracyclines
ANS: C
Sulfonamides achieve very high concentrations in the kidneys, through which they are eliminated. Therefore, they are often used in the treatment of urinary tract infections.
During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by which of these?
a. Large doses of antibiotics that kill normal flora
b. The infection spreading from the lungs to the new site of infection
c. Resistance of the pneumonia-causing bacteria to the drugs
d. An allergic reaction to the antibiotics
ANS: A
Normally occurring bacteria are killed during antibiotic therapy, allowing other flora to take over and resulting in superinfections. The other options are incorrect.
The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?
a. Antiseptics are used to sterilize surgical equipment.
b. Disinfectants are used as preoperative skin preparation.
c. Antiseptics are used only on living tissue to kill microorganisms.
d. Disinfectants are used only on nonliving objects to destroy organisms.
ANS: D
Antiseptics primarily inhibit microorganisms but do not necessarily kill them. They are applied exclusively to living tissue. Disinfectants are able to kill organisms and are used only on nonliving objects.
A patient with a long-term intravenous catheter is going home. The nurse knows that if the patient is allergic to seafood, which antiseptic agent is contraindicated?
a. Chlorhexidine gluconate
b. Hydrogen peroxide
c. Povidone-iodine
d. Isopropyl alcohol
ANS: C
Iodine compounds are contraindicated in patients with allergies to seafood. The other options are incorrect.
During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)
a. Wheezing
b. Diarrhea
c. Shortness of breath
d. Swelling of the tongue
e. Itching
f. Black, hairy tongue
ANS: A, C, D, E
Hypersensitivity reactions may be manifested by wheezing; shortness of breath; swelling of the face, tongue, or hands; itching; or rash.