antibiotics: for UTI, celullitis, PI, osteomyelitis Flashcards
textbook
Superinfections are an adverse effect common to
all antibiotic therapy. Which of the following best
describes a superinfection?
1. An initial infection so overwhelming that it
requires multiple antimicrobial drugs to treat
successfully
2. Bacterial resistance that creates infections that are
difficult to treat and are often resistant to multiple
drugs
3. Infections requiring high-dose antimicrobial therapy with increased chance of organ toxicity
4. The overgrowth of normal body flora or of opportunistic organisms, such as viruses and yeast, no
longer held in check by normal, beneficial flora
Answer: 4 Rationale: When normal host flora are
decreased or killed by antibacterial therapy, opportunistic organisms such as viral and fungal infections may
occur. Options 1, 2, and 3 are incorrect. Bacterial resistance and organ toxicity may be adverse drug effects
of antibacterial therapy but do not describe superinfections. The use of multiple antibiotics for severe infections is a therapeutic use of the drugs.
in ciprofloxacin and vancomycin
chapter 35 drugs for bacterial infections
A patient will be discharged after surgery with a
prescription for penicillin. When planning at-home
instructions, what will the nurse include?
1. Penicillins can be taken while breastfeeding.
2. The entire prescription must be finished.
3. All penicillins can be taken without regard to
eating.
4. Some possible side effects include abdominal pain
and constipation.
Answer: 2 Rationale: Many people will discontinue
medication after improvement is noted. All antibiotic
regimens must be completed to prevent recurrence of
infection unless allergy or significant adverse effects
occur that warrant discontinuing or changing the drug
used. Options 1, 3, and 4 are incorrect. Some penicillins
(e.g., amoxicillin) should be taken with meals, whereas
all others should be taken 1 hour before or 2 hours after
meals. Penicillins should be used with caution during
breastfeeding. Penicillins, along with other antibiotics, tend to cause diarrhea, not constipation
chapter 35 drugs for bacterial infections
What important information should be included in
the patient’s education regarding taking ciprofloxacin
(Cipro)?
1. The drug can cause discoloration of the teeth.
2. Fluid intake should be decreased to prevent urine
retention.
3. Any heel or lower leg pain should be reported
immediately.
4. The drug should be taken with an antacid to
reduce gastric effects
Answer: 3 Rationale: Fluoroquinolones such as ciprofloxacin (Cipro) have been associated with an increased
risk of tendinitis and tendon rupture. Any heel or lower leg pain should be reported immediately for evaluation. Options 1, 2, and 4 are incorrect. Ciprofloxacin will not cause discoloration of the teeth, and fluids should be encouraged during use of the drug. Taking antacids concurrently with ciprofloxacin may significantly
impair absorption of the drug.
chapter 35
A patient taking trimethoprim-sulfamethoxazole (Bactrim, Septra) develops a reddish-purplish papular rash
surrounded by areas of erythema. The rash should be
evaluated by the healthcare provider because it may
indicate which skin condition?
1. A fungal superinfection
2. Viral skin eruptions
3. Dermatologic toxicity, including Stevens–Johnson
syndrome
4. Nonadherence with drug therapy
Answer: 3 Rationale: TMP-SMZ causes dermatologic toxicities, including Stevens–Johnson syndrome. Unusual,
blistering-type rashes with purplish-red discoloration
should be immediately reported to the provider.
Options 1, 2, and 4 are incorrect. Fungal superinfections may be wet or dry and are reddened, possibly
denuded areas. Viral eruptions are most often vesicular
rashes. Nonadherence to drug therapy would not result
in a rash.
chapter 36
A patient has been diagnosed with tuberculosis and is
prescribed Rifater (pyrazinamide with isoniazid and
rifampin). While the patient is on this medication, what
teaching is essential? (Select all that apply.)
1. “It is critical to continue therapy for at least 6 to
12 months.”
2. “Two or more drugs are used to prevent tuberculosis bacterial resistance.”
3. “These drugs may also be used to prevent
tuberculosis.”
4. “No special precautions are required.”
5. “After 1 month of treatment, the medication will
be discontinued.”
Answer: 1, 2, 3
Rationale: It is critical that the medicine
be taken for 6 to 12 months, and possibly as long as
24 months in order for it to effectively treat the tuberculosis bacterium. Antitubercular drugs such as pyrazinamide, isoniazid (INH), and rifampin are also used for prevention and treatment of clients who convert from a negative TB test to a positive, although single
drug use is most often prescribed in that situation.
Multiple drug therapy is necessary because the mycobacteria grow slowly, and resistance is common. Using multiple drugs in different combinations during the long treatment period lowers the potential for resistance and increases the chances for successful therapy.
Options 4 and 5 are incorrect. Precautions to avoid adverse effects are required and the drugs will be required much longer than 1 month.
