Infection Flashcards
Penicillin drugs, action, side effects, nursing interventions?
Drugs: Penicillin G, Oxacillin, amoxicillin, ampicillin, piperacillin.
Action: Disrupt cell walls, 15-30% absorbed orally; short half-life orally.
Side effects: No common side effects. Allergy (rash, pruritis, fever)
Nursing Actions: Do not take w/ fruit juices, IV - phlebitis, IM - large muscle, High doses - bleeding disorders, < effectiveness of oral contraceptives.
Cephalosporins drugs, action, side effects, nursing interventions?
Drugs: Cephalexin, cefaclor, ceftriaxone, cefepime
Actions: Disrupt cell walls
Side effects: Diarrhea, nausea, abdominal cramping, rash, superinfections w/ prolonged use.
Nursing interventions: Nephrotoxic
Tetracyclines drugs, action, side effects, nursing interventions?
Drugs: Doxycycline, tetracycline
Action: Inhibit protein synthesis
Side effects: Superinfections, nausea, vomiting, diarrhea, discoloration of teeth, photosensitivity
Nursing interventions: Tak eon empty stomach w/ water; dairy, iron, Ca, Al interfere w/ absorption. Additional contraceptive. Do not use in pregnancy; child < 8. Photosensitivity, nephrotoxic, hepatotoxic, expired - toxic.
Macrolides drugs, action, side effects, nursing interventions?
Drugs: Erythromycin, azithromycin
Action: Bind w/ ribosomes
Side effects: N&V, abdominal cramping
Nursing interventions: Give empty stomach w/ full glass of water, DO NOT GIVE W/ FRUIT JUICE, Hepatotoxic in high doses.
Aminoglycosides drugs, action, side effects, nursing interventions?
Drugs: Gentamicin, Tobramycin, streptomycin
Action: Inhibit protein synthesis
Side effects: N&V, fatigue, rash, nephrotoxic, ototoxic
Nursing Interventions: Not absorbed orally, monitor kidney function, hearing, peak & trough levels.
Fluoroquinolones drugs, action, side effects, nursing interventions?
Drugs: Ciprofloxacin, levofloxacin
Action: interfere with DNA
Side effects: N&V, diarrhea, rash, headache
Nursing interventions: Take w/ food, do not take w/ Ca, Mg, iron, zinc, multivitamins or minerals (< absorption up to 90%), Nephrotoxic , Tendonitis, < cartilage development.
Sulfonamides drugs, action, side effects, nursing interventions?
Drugs: Trimethoprim-sulfamethoxazole
Action: Inhibit synthesis of folate
Side effects: N&V, crystalluria
Nursing interventions: > fluid intake to 2.5-3L/day. Monitor kidney function, photosensitivity.
Classification of amoxicillin?
Antibiotic (anti-infective)
Uses/action for amoxicillin?
Infections of ear, nose, throat, GU tract, skin & soft tissue, gonorrhea.
Broad spectrum; destroys bacterial cell wall.
Interactions for amoxicillin?
Oral contraceptives (< efficacy)
anticoagulants (prolongs bleeding time)
Side effects of amoxicillin?
None common - reactions are usually severe (anaphylaxis)
Why would the health care provider not use a tetracycline to treat Dawn’s ear infection?
Tetracyclines are contraindicated in children under age 8 due to discoloring of teeth and effects on bone growth.
Dawn is prescribed amoxicillin for 7 days. 10 days later she continues to complain of ear pain. Why might this occur?
The medication was not effective against the organism causing the infection.
Classification for Sulfamethoxazole-trimethoprim (Bactrim, septra)?
Anti-infective; sulfonamide.
Contraindications for sulfamethoxazole-trimethoprim (Bactrim, Septra)?
Anemia due to folate deficiency
hyperkalemia
pregnancy & lactation
Uses/action for sulfamethoxazole-trimethorpim (Bactrim, Septra)?
Action - inhibits RNA synthesis
Use - PCP, UTIs, Otitis media, chronic bronchitis, traveler’s diarrhea
Interactions with Sulfamethoxazole-trimethorpim (Bactrim, Septra)?
Oral anticoagulants (> bleeding)
Alcohol
Side effects for Sulfamethoxazole-trimethoprim?
Rash
Nausea
Vomiting
Anorexia
Crystalluria
Nursing interventions for Sulfamethoxazole-trimethoprim?
Monitor coagulation times if also receiving anticoagulants
Older adults - monitor for thrombocytopenia (bruising, bleeding)
Monitor I&O & kidney function
Drink 2.5-3L of fluid per day
Report rash, sore throat, fever, Purpura, jaundice - early signs of serious reaction
Classification for azithromycin (Zithromax)?
Macrolide antibiotic
Contraindications for azithromycin (Zithromax)?
Uses: pneumonia, lower respiratory infections, pharyngitis/tonsillitis, gonorrhea, skin infections, otitis media, sinusitis.
Interactions with azithromycin (Zithromax)?
Antacids
Food < absorptions by 50%
Statin drugs
St. John’s wort
GRAPEFRUIT
Side effects of azithromycin (Zithromax)?
Pruritis
Rash
Nausea
Vomiting
Diarrhea
Nursing interventions for Azithromycin (Zithromax)?
Monitor liver function
Give on empty stomach
Minimize direct sunlight exposure
Antacids - 2 hrs before or after drug
Classification for Ciprofloxacin (Cipro)?
Fluoroquinolone antibiotic
Contraindications for Ciprofloxacin (Cipro)?
Viral infections
Myasthenia gravis (weakness and rapid fatigue of muscles under voluntary control)
Peripheral neuropathy
Tendon inflammation or tendon pain
Uses/action of Ciprofloxacin (Cipro)?
Action: Inhibits DNA
Use: UTIs, URI, skin, bone, joint infections, GI infections, diarrhea, chronic bacterial prostatitis, pneumonia, acute sinusitis, otitis external, conjunctivitis
Interactions with Ciprofloxacin (Cipro)?
Theophylline
Antacids
Calcium & Iron (< absorption of Cipro)
Side effects of Ciprofloxacin (Cipro)?
None common
Nursing interventions for Ciprofloxacin (Cipro)?
Do not give within 4 hrs of antacids
Give w/ food; restrict caffeine
May cause false positive for opiates
Report tendon inflammation/pain
Monitor renal function, S/S crystalluria
Monitor for GI irritation
Monitor for superinfections
Photosensitivity
If on anticoagulants - monitor bleeding times (PT, INR)
Classification for vancomycin?
Antibiotic; glycopeptide
Contraindications for Vancomycin?
Allergy to corn
Previous hearing loss
Uses/action for vancomycin?
Action: bactericidal - < RNA synthesis, alters cell wall
Uses: C diff, staph, enterocolitis
Interactions with vancomycin?
Don’t use with other drugs that are also ototoxic & nephrotoxic
Side effects of Vancomycin?
Hypotension w/ flushing
Erythematous rash on face & upper body (rapid IV infusion) - red man or red neck syndrome
Nursing interventions for vancomycin?
Monitor BP & HR throughout treatment
Assess hearing - loss of hearing may be permanent. Notify ringing in ears.
Monitor kidney function
Peak & trough levels
Classification for Metronidazole (flagyl)?
Amebicide
Contraindications for metronidazole (flagyl)?
Alcohol within 3 days
Blood dyscrasias (disease or disorder of the blood)
CNS disease
Abnormal neurological signs
Lactation
Uses/action for metronidazole (flagyl)?
Action: Trichomonacidal, amoebicidal & antibacterial
Uses: intestinal amebiasis, amebic liver abscess, Pre-op prophylaxis in GI surgeries, hysterectomy, appendectomy
Interactions with metronidazole (flagyl)?
Oral anticoagulants
Alcohol
Anti-virals
NTG (Nitroglycerin; nitrate medication)
Side effects of metronidazole (Flagyl)?
Candida
Nausea
Superinfections
Nursing interventions for metronidazole (flagyl)?
Warn patient causes metallic taste in mouth
Observe for fluid retention
Repeat feces exam in 3 months
Monitor WBC count
Sexual partners - use condone, partners treated also
No alcohol
Monitor for CNS toxicity
Urine dark reddish brown
Report overgrowth of candida
Take pill whole, on an empty stomach
While hospitalized Vera develops thrush, a fungal infection in the mouth. What is this type of infection called?
Superinfection
The health care provider prescribes nystatin. The nurse teaches Vera to take this medication in what manner?
Swish and swallow
What are two drugs used to treat tuberculosis?
Isoniazid
Rifampin
Isoniazid treatment for, action, side effects, Nursing interventions?
Treatment for: Tuberculosis
Action: Inhibits cell wall
Side effects: Peripheral neuropathy; seizures, dizziness, memory loss, psychoses, nausea, vomiting, diarrhea, abdominal pain
Nursing interventions: 10% of pts develop resistance, Monitor liver function, monitor BP - orthostatic hypotension, monitor diabetics for loss of glycemic control, avoid alcohol, supplement vitamin B6
Rifampin treatment for, action, side effects, nursing interventions?
Treatment for: tuberculosis
Action: inhibits DNA & RNA
Side effects: heartburn, epigastric distress, nausea, vomiting, anorexia, flatulence, cramps, diarrhea, > LFTs (liver function tests)
Nursing interventions: Monitor LFTs, body secretions, sclera, etc - harmless red-orange color, < effectiveness of oral contraceptives
Who should be prescribed prophylactic treatment for exposure to TB?
Family members w/ close contact; health care workers providing care
What medication is usually prescribed as prophylactic treatment for TB and how long is it usually taken?
Isoniazid - 6 months
Classification for FLuconazole (Diflucan)?
Azole antifungal
Contraindications for Fluconazole (Diflucan)?
Liver disease
Lactation
Uses/action for Fluconazole (Diflucan)?
Action: interferes w/ cell membrane
Uses: Meningitis, candidiasis, vaginal candidiasis (candidiasis = yeast infection)
Interactions with Fluconazole (Diflucan)?
Warfarin
Hypoglycemia w/ sulfonylureas
Prolonged effects of opiates
Side effects of Fluconazole?
None common
Nursing interventions for Fluconazole?
Monitor kidney & liver function
Monitor glycemic control for diabetics
Nursing care common to all anti-infective drugs
1) Encourage fluid intake
2) culture & sensitivity first
3) side effects
——— Question type of reaction
——— Common SE: N&V, diarrhea
4) take entire prescription; space evenly
5) reduce effectiveness or oral contraceptives
