Mycobacterial, Fungal, and Parasitic Infections Flashcards
What are acid-fast bacteria?
These are bacteria that cause TB
called that because of the staining technique used to identify them
What is the big issue with TB treatment? How long can it take?
TB is very slow growing
This means that treatment takes longer (up to 24 months)
With the longer term treatment for TB what does this increase the risk of?
Toxicity
poor client adherence
resistance to develop (bacteria)
What is the therapeutic response of antimycobacterials?
bacteriostatic by inhibiting bacterial protein synthesis; indicated for active and inactive TB
What is another first line antimycobacterial other than INH?
rifampin (Rifadin)
Will multiple antimycobacterial drugs be used simultaneously during treatment sometimes?
YES YES YES (3-4 usually)
What are some adverse effects of antimycobacterials?
peripheral neuropathy (from B6 (pyridoxine) deficiency) - INH
hepatotoxicity - both
hyperglycemia in diabetics - both
doscolored bodily fluids - Rifampin
What are some nursing considerations for antimycobacterials?
Take multivitamin with 50-200mg B6 daily (INH peripheral neuropathy)
monitor liver function and report symptoms of dysfunction (both)
monitor BG in diabetics (both hyperglycemia)
discolored body fluids is harmless (Rifampin)
What are some patient teaching points for antimycobacterials?
THE USUAL!!
avoid alcohol (both)
report signs of liver failure… abd pain, jaundice, n/v, decreased appetite (both)
take B6 daily (INH)
body fluid changes are harmless (Rifampin)
take 1 or 2 hours before meals on empty stomach (both)
What is the desired outcome of antimycobacterial treatment?
resolution of symptoms
AND
3 negative sputum cultures (usually takes 3-6 months)
What is the therapeutic outcome of antiprotozoals?
cell death resulting in relief of symptoms
BROAD SPECTRUM (SUPRAINFECTION RISK)
What are antiprotozoals used to treat?
protozoal infections (giardiasis (STI), trichomoniasis (STI), C. diff)
What are some adverse effects for antiprotozoals?
n/v
dry mouth
METALLIC TASTE
CNS - HA, ataxia, peripheral neuropathy
darkening of urine - harmless
What are some nursing considerations for antiprotozoals?
report n/v, dry mouth, metallic taste
report and stop taking medication if CNS symptoms arise (HA, ataxia, peripheral neuropathy)
darkening of urine is harmless (make sure patient knows)
What are some patient teaching points for antiprotozoals?
THE USUAL
avoid with alcohol - disulfiram reaction!
What is the therapeutic action of antifungals?
fungacidal or fungastatic depending on the drug and fungus.
What are some adverse effects for antifungals?
hepatotoxic
irregular menstrual cycles, gynecomastia, erectile dysfunction
What are some nursing considerations and patient teaching points for antifungals?
monitor and report signs of liver dysfunction
monitor and report irregular menstrual cycles, gynecomastia, and ED
What is amphotericin B? What is it used for?
a fungacidal (antifungal) that is reserved for life-threatening infections because of its toxicity.
ONLY GIVEN IV IN THE HOSPITAL
What are some adverse effects of amphotericin B?
nephrotoxicity
bone marrow suppression
hypokalemia
What are some nursing considerations for amphotericin B?
monitor and report signs of nephrotoxicity (labs,urine output), administer 1-2L of fluids on days of administration
monitor baseline CBC and monitor CBC weekly, monitor for bleeding, bruising, and signs of infection as well (bone marrow suppression)
Monitor and administer potassium supplements as ordered (hypokalemia)
What are two things we have to worry about that have to do with administration of amphotericin B? What is the best way to prevent these?
INFUSION REACTION (fever, chills, rigidity, HA) 1-3 hours after infusion has begun) pretty common… - infuse over 2-4 hours (nurses sometimes stay in patients room for whole infusion while charge nurse cares for nurses other patients), administer a 1mg test dose through IV slowly, pretreat with antihistamines or acetaminophen.
Thrombophlebitis at infusion site - closely monitor for erythema and swelling, use a large vein or central line for administration.
if an infusion reaction happens with amphotericin B, what should the nurse do?
Stop the infusion and wait for further orders from the doctor, usually meperidine (Demerol), dantrolene (Dantrium), and hydrocortisone are given to reduce symptoms.
