Quiz 3 Concepts Flashcards
What is important to know when administering meds with a narrow therapeutic index?
there is a limited range between the therapeutic dose and the toxic dose so serum peak and trough levels have to be monitored
What can you do to make sure you are obtaining the most accurate culture?
obtain the specimen before antibiotic therapy begins
A pt. taking antibiotics develops mouth sores. What does this indicate and what should be done?
this indicates a superinfection but the drug does not need to be held
Cefazolin in high doses will increase what in a patient?
BUN, creatinine, AST, ALT, ALP, LDH, and bilirubin
What occurs with the frequent use of antibiotics?
frequent use of antibiotics increases exposure of bacteria and increases the bacteria’s resistance to those meds
What can occur if you skip a dose of an antibiotic?
skipping doses is incomplete treatment of an infection and the remaining bacteria may develop resistance
What can happen if you treat viral infections with antibiotics
it can cause resistance to develop from unneeded exposure
Macrolide
broad-spectrum antibacterial that treats whooping cough and Legionnaires disease
S: dysrhythmia, nausea, vomiting, diarrhea, ototoxicity
O: cardiac, GI, ear
C: proto is erythromycin, take on an empty stomach, advise the client to report palpitations, caution for pts. w/ liver or GI disorders
What can occur when taking macrolides in high doses with other hepatotoxic drugs?
it can cause hepatotoxicity so liver enzymes should be monitored
What can occur if macrolides are taking with warfarin?
it can increase the serum level
Why shouldn’t tetracyclines be given to children younger than 8 years old?
they irreversibly discolor the teeth
Tetracyclines
treat chlamydia and other gram-negative bacteria
S: nausea, vomiting, diarrhea, hepatotoxicity, suppressed bone growth
O: GI, liver, bones, integumentary
C: administer 1 hour before meals or 2 hours after but not before bedtime, caution for pregnant women and liver impairment
K: can interact with calcium and antacids, monitor for jaundice, not for pregnant women
What can high doses of tetracyclines cause?
nephrotoxicity
Gentamicin
an aminoglycoside that is a narrow spectrum and can treat e.coli and pneumonia, intake and output needs to be monitored for kidney function
When taking gentamicin and the pt. notices a change in urine output, what should occur?
notify the provider, and obtain the serum trough levels to make sure the drug is not at a toxic level
Aminoglycosides
treats e.coli and pneumonia
S: ototoxicity and nephrotoxicity
O: ear, kidney
C: proto is gentamicin, monitor for reports of tinnitus and vertigo, check I & O
K: ototoxicity is the biggest adverse effect
Fluoroquinolone
treat UTIs, protect from anthrax, and treats other bacterial infection
S: nausea, vomiting, diarrhea, dizziness, photosensitivity
O: GI, CNS, integumentary, skeletal
C: prototype is ciprofloxacin, monitor for CNS symptoms, decrease caffeine intake
What effects does fluoroquinolones have on blood sugar levels?
fluoroquinolones can increase the effect of oral hypoglycemic med so monitor glucose levels
When taking sulfonamides, what should be done?
several quarts of water should be drunk daily to prevent crystalluria
Sulfonamides
treat UTIs, chronic bronchitis
S: nausea, vomiting, blood disorders, renal damage, skin reactions
O: GI, cardiac, kidney, integumentary
C: proto is a combo of trimethoprim and sulfamethoxazole, monitor GI symptoms, advise to drink 1200-1500 ml of water, monitor for low counts of CBCs and platelets
K:
If you touch somebody with tuberculosis, what do you have to do?
prophylactic treatment with antitubercular therapy
For pts taking antitubercular drugs, what can be done to prevent resistance to the antitubercular drugs?
multi drug therapy
What is an adverse reaction to INH and what can be given to prevent this?
peripheral neuropathy, pyridoxine
A patient is taking rifampin and notices their urine is a red-orange color. What is your next step?
ensure them that rifampin causes harmless discoloration of body liquids, also advise them to not wear contact lenses to avoid staining
When should influenza neuraminidase inhibitors, such as zanamivir or oseltamivir, be taken?
within 48 hours of onset of symptoms for best effect
What is phenazopyridine used for?
it treats symptomatic pain relief for cystitis
What needs to be reported when taking Ditropan?
urinary retention but dry mouth, fatigue, and tachycardia
What needs to be assessed when taking methchlorethamine?
tissue necrosis
if there is pain at the IV site, the nurse stops the infusion
What effects does diphenhydramine have on children?
excitation
When should antacids be given?
1-3 hours after eating and at bedtime bc maximum acid secretion occurs
When treating H. pylori peptic ulcer disease, how many antibiotics should be given?
two antibiotics bc h. pylori develops resistance rapidly
How do proton pump inhibitors affect digoxin?
they enhance the effects of digoxin
When taking levothyroxine, what needs to be increased?
insulin and oral antidiabetics should be increased bc levothyroxine decreased the effects of these drugs
-monitor for hyperglycemia
What should pts with hyperthyroidism be advised about?
iodine and how it is present in salt and shellfish
What is propylthiouracil and what is it used for?
potent antithyroid drug that is used to prep for a subtotal thyroiddectomy
When is calcitriol given?
to manage hypocalcemia caused by parathyroid hormone defiency
What is lipo hypertrophy and what can cause it?
a raised lump on the skin caused by repeated injections into the same site
-this can interfere with insulin absorption
Where should insulin be stored?
if it’s open, it can be stored at room temp for a month or refrigerated for 3 months
Should ketoconazole be given with food?
yes
What is topical miconazole used for?
vaginal candidiasis
What is promethazine contraindicated for?
glaucoma, bc its anticholinergic
What is a side effect of chloroquine?
visual injury bc of blurred vision and visual changes should be reported
For patients taking drugs for ulcers, what should they be educated on?
the ulcer pain may subside in days but healing takes 1-2 months
The transdermal scopolamine patch lasts 72 hours. When should it be taken off?
every 3 days
What can glucocorticoids cause?
hyperglycemia
When administering tolterodine tartrate, what effect does it have on bowel sounds?
it decreases bowel sounds and causes paralytic ileus
