Module 11A CH9 Antibiotics Flashcards

Question

FLUOROQUINOLONES | Contraindication

Answer 1

• Known allergy, pregnancy and lactation, and renal dysfunction ``` Contraindication ns • Most common: CNS - headache, dizziness, insomnia, depression, hallucinations • Black box warning: risk for tendinitis and tendon rupture Adverse Effects • Iron salts, sucralfate, mineral supplements, antacids • Quinidine • Theophylline • NSAIDs Drug-Drug Interactions ```

Answer 2

• Assessment • History: Allergy; myasthenia gravis; renal disease; pregnancy or lactation • Physical exam • Examine for rash or lesions; Orientation, affect, and reflexes • Perform culture and sensitivity tests at the site of infection • Monitor appropriate labs: renal function • Nursing Diagnoses • Acute pain • Deficient fluid volume • Imbalanced nutrition: Less than body requirements • Deficient knowledge • Implementation • Check culture and sensitivity reports • Monitor renal function tests before initiating therapy • Ensure patient receives the full course as prescribed • Monitor the site of infection and presenting signs and symptoms • Small, frequent meals as tolerated, mouth care, ice chips, sugarless candy • Safety measures • Provide patient teaching • Evaluation • Patient response • Effectiveness of teaching plan • Effectiveness of comfort and safety measures • Compliance with regimen

Answer 3

``` • Broad spectrum use Indicati ons • Bactericid al Actions • Penicillin G benzathine • Penicillin G potassium • Penicillin G procaine • Penicillin V • Amoxicillin • Ampicillin Common medicati ons “- icillin” ```

Answer 4

• Allergies to penicillin or cephalosporins • Renal diseaseContraindications • Pregnancy and lactationCaution • Most significant GI tractAdverse Effects • Tetracyclines, aminoglycosides Drug–Drug Interactions

Answer 5

``` • Assessment • History: Allergy; renal disease; pregnancy or lactation • Physical exam • Examine skin and mucous membranes for rashes or lesions • Injection sites for abscess formation • Respiratory status • Abdominal assessment • Monitor appropriate labs • Nursing Diagnoses • Acute pain • Imbalanced nutrition: Less than body requirements • Deficient knowledge • Implementation • Check culture and sensitivity reports • Monitor renal function tests before and periodically during therapy • Ensure that the patient receives the full course as prescribed • Monitor the site of infection and presenting signs and symptoms • Small, frequent meals, frequent mouth care, offer ice chips or sugarless candy, provide adequate fluids • Monitor the patient for any signs of superinfection • Monitor and care for injection sites • Provide patient teaching • Evaluation • Patient response to drug • Effectiveness of teaching plan, comfort and safety measures, and compliance with regimen ```

Answer 6

``` Action • Bacteriostatic by inhibiting folic acid synthesis Indications • Treatment of infections caused by gram- negative and gram- positive bacteria ```

Answer 7

``` Most common medications (“- sulfa”) • sulfadiazine • sulfasalazine • trimethoprim- sulfamethoxazole ```

Answer 8

Contraindications • Known allergy to any sulfonamide or thiazide diuretics • Pregnancy: Teratogenic • GI symptoms • Renal effects related to the filtration of the drugAdverse Effects • tolbutamide, tolazamide, glyburide, glipizide, or chlorpropamide • Cyclosporine Drug-Drug Interactions

Answer 9

• Assessment • History: Allergy; renal disease; pregnancy or lactation • Physical Exam • Examine skin for rash or lesions; respiratory status; orientation, affect, and reflexes; abdominal status • Obtain specimens for culture and sensitivity tests at the site of infection • Monitor appropriate labs: renal function and CBC • Nursing Diagnoses • Acute pain • Disturbed sensory perception • Imbalanced nutrition: Less than body requirements • Deficient knowledge • Implementation • Check culture and sensitivity reports • Monitor renal function tests before and periodically during therapy • Ensure that the patient receives the full course as prescribed • Take oral drug on empty stomach 1 hour before or 2 hours after meals with full glass of water • Discontinue immediately if hypersensitivity reactions occur • Small, frequent meals and adequate fluids; frequent mouth care, ice chips or sugarless candy • Monitor CBC and urinalysis test results before and periodically during therapy

Answer 10

Action • Bacteriostatic ``` Indications • Treatment of various infections • Substitute for PCN when it is contraindicated • Acne when penicillin is contraindicated ``` ``` Most common medications “- cycline” • tetracycline • doxycycline • minocycline ```

Answer 11

``` Contraindicati ons Known allergy to tetracyclines or to tartrazine Pregnancy and lactation Renal and hepatic dysfunction Adverse Effects Most GI, but possible damage to the teeth and bones ```

Answer 12

``` Penicillin G, oral contraceptiv e therapy Digoxin Drug-Food Interactions Administer on empty stomach ```

Answer 13

• Assessment • History and physical exam • Allergy; renal or hepatic disease; pregnancy or lactation • Examine the skin for rash or lesions; respiratory status • Perform culture and sensitivity tests at the site of infection • Monitor appropriate labs: renal and hepatic function • Nursing Diagnoses • Diarrhea related to drug effects • Imbalanced nutrition: Less than body requirements related to GI effects, alteration in taste, and superinfections • Impaired skin integrity related to rash and photosensitivity • Deficient knowledge regarding drug therapy • Implementation • Check culture and sensitivity reports • Monitor renal and liver function test results before and periodically during therapy • Ensure that the patient receives the full course as prescribed • Take on empty stomach with a full 8-oz glass of water • Discontinue the drug immediately if hypersensitivity reactions occur • Small, frequent meals, frequent mouth care, ice chips or sugarless candy • Monitor for signs of superinfections • Encourage the patient to apply sunscreen and wear clothing • Provide patient teaching

Answer 14

``` • Bactericidal • Act on the DNA of the bacteria leading to lack of growth and eventual bacterial death for TB and Leprosy Action • Treatment of TB and Leprosy ``` ``` Indicati ons Antituberculosis drugs • Rifampin • Pyrazinamide • Ethambutol • Streptomycin • Isoniazid Leprostatic drugs • Dapsone ```

Answer 15

``` Allergy Renal or hepatic failure CNS dysfunction Pregnancy and lactation Adverse Effects CNS effects and GI irritation Drug-Drug Interactions Rifampin and isoniazid can cause liver toxicity ```

Answer 16

• Assessment • History: Allergy; renal or hepatic disease; CNS dysfunction; pregnancy • Physical exam • Examine the skin for rash or lesions; orientation, affect, and reflexes; respiratory status • Obtain specimens for culture and sensitivity testing • Monitor appropriate labs: liver and renal function • Nursing Diagnoses • Imbalanced nutrition: Less than body requirements • Disturbed sensory perception (kinesthetic) • Acute pain • Deficient knowledge • Implementation • Check culture and sensitivity reports • Monitor renal and liver function test results before and periodically during therapy • Ensure that the patient receives the full course of the drugs • Discontinue drug immediately if hypersensitivity reactions occur • Small, frequent meals, perform frequent mouth care, and drink adequate fluids • Provide patient teaching • Evaluation • Patient response to the drug • Effectiveness of teaching plan • Effectiveness of comfort and safety measures • Compliance with regimen

Answer 17

``` Lincosamides clindamycin, lincomycin Lipoglycopeptid es telavancin, dalbavancin, oritavancin, vancomycin Macrolides erythromycin, azithromycin, clarithromycin, fidaxomicin Oxazolidinones tedizolid, linezolid Monobactam aztreonam ```

Answer 18

• Assessment • History: Allergy; renal or liver disease; pregnancy or lactation • Physical exam • Examine the skin • Orientation, affect, reflexes • ECG • Specimens for culture and sensitivity testing from the site of infection • Monitor labs: renal and hepatic function • Nursing Diagnoses • Acute pain • Risk for infection • Deficient knowledge • Implementation • Labs: culture & sensitivity, hepatic and renal function tests • Complete course of antibiotics • Swallow the tablet whole; it should not be cut, crushed, or chewed • Monitor the site of infection and presenting signs and symptoms • Small, frequent meals as tolerated; frequent mouth care and ice chips or sugarless candy • Ensure ready access to bathroom facilities • Institute safety measures • Arrange for appropriate treatment of superinfections as needed • For lincosamides: careful monitoring of GI activity and fluid balance • For lipoglycopeptides: obtain a baseline QT interval on ECG; alert patient to possible foamy urine; ensure patient is not pregnant or planning to be pregnant • Provide patient teaching • Evaluation • Monitor the patient’s response • Evaluate the effectiveness of the teaching plan, comfort measures, and safety measures • Compliance with the regimen