Big Guns Antibiotics (ABX)

Question 1

What do you check before giving VancoMYCIN?

Answer 1

BUN (10-20 mg/dL) 15 minutes before the “next dose” or “administration

Question 2

What do you have to watch out for patient taking VancoMYCIN?

Answer 2

TOXICITY : Ototoxicity (ear damage) = Vertigo (loss of balance), Ataxia = inability to walk.
Tinnitus (ringing of the ears) - 1st indication of Kidney toxicity.
NEPHROTOXICITY (Kidney damage) = report to HCP increasing BUN (over 20 = bad for the Kidney) & Creatinine (over 1.3 = Kidney Injury), Urine output (30ml/ less =Kidney Distress)

Question 3

What is the specific function of VancoMYcin?

Answer 3

To treat serious infection such as MRSA & C DIFF (Clostridium Difficile = causes diarrhea & colitis; infla. of the colon)

Question 4

What is the preferred route of administration for VancoMYCIN & why?

Answer 4

PICC Line due to it’s burning effect causing THROMBOPHLEBITIS & is very irritating to tissues.

Question 5

When & what do you assess at the site of patient taking VancoMYCIN IV?

Answer 5

Check for any PAIN, REDNESS & SWELLING every 30 MINS. (Thrombophlebitis). Make sure IV is working & patent before the administration.

Question 6

What do you watch out for if there is a rapid infusion of VancoMYCIN IV?

Answer 6

“Red Mans Syndrome”: sudden onset of HYPOTENSION, FLUSHING & PRURITUS (itchiness), BIG RED RASHES ON FACE, NECK CHEST & EXTREMITIES (*not an allergic reaction)

Question 7

What do you do & how can you prevent RED MANS SYNDROME?

Answer 7

Monitor BP & SLOW INFUSION (atleast OVER 60 MINUTES {<10MG/MIN.}) “FAST INFUSION means FLUSHING”

Question 8

What are the classical Signs of ANAPHYLAXIS & what is your initial Nursing action?

Answer 8

Hives
Angioedema
Wheezing
Stop infusion immidiately & administer
Epinephrine

Question 9

Acronym for EPINEPHRINE Indication?

Answer 9

E - Edema “Angioedema”
P - Pruritus
H - Hives
I - Inspiratory/expiratory “Wheezes”

Question 10

What are some Nursing Consideration in taking VancoMYCIN?

Answer 10

no effect on Magnesium (Mg); No effect on Mental Status or Deep Tendon Reflexes (DTRs); No need for Anti-emetic meds. (N&V)

Question 11

What is the indication for giving AMINOGLYCOSIDES (NeoMYCIN)?

Answer 11

Use to treat infection in Cystic Fibrosis

Question 12

What is the difference between GLYCOPEPTIDES (Vancomycin) & AMINOGLYCOSIDES (Neomycin)?

Answer 12

There’s no “Red mans Syndrome” in Aminoglycosides, but
Very TOXIC if given in COMBINATION (Otoxic = stop medication to prevent DEAFNESS ; Nephrotoxic = Notify HCP of Increasing BUN/Creatinine)

Question 13

Risk Factors for AMINOGLYCOSIDES (NeoMYCIN)?

Answer 13

ELDERLY population, DECREASE RENAL FUNCTION (Kidney Failure, Urinary Retention) & giving in HIGH DOSES

Question 14

What is the CONTRAINDICATION for AMINOGLYCOSIDES?

Answer 14

NEUROMUSCULAR DISEASE

Question 15

SIDE EFFECTS of AMINOGLYCOSIDES?

Answer 15

MUSCLE CRAMPS & MUSCLE ACHES

No need to notify HCP & No need to stop infusion