NUR 3145 Exam 2 Study Questions and Correct Answers
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Course
NUR 3145
Institution
NUR 3145
Destroy growth of bacteria or fungi Bactericidal
Inhibit growth of bacteria or fungi Bacteriostatic
Primary goals of antimicrobial agents -Destroy (or inhibit growth of) bacteria -At the same time, not harm host tissue
General Adverse Reactions Determine any previous allergy or adverse reactions...
superinfection ✅Eradication or reduction of normal flora growth
Allows growth of other flora
Candida endogenous to body
Overgrowth
AKA yeast infection
Thrush
,S/Sx: fever, perineal itching, cough, lethargy, or any unusual discharge
General Guidelines ✅Identify infecting organism
Follow agency guidelines
Collect specimens
Culture and sensitivity (C & S)
Obtain before giving first dose of antibiotic
Take specimen immediately to lab
Treatment begun
Based on tentative microorganism ID
Broad-spectrum antibiotics
Combinations
C & S results return
Antibiotics changed to one that will fight infection best
Blood levels drawn for therapeutic levels
peak levels ✅Highest blood level
Drawn 30 minutes after dose is administered (completed)
treatment considerations: patient defense mechanisms ✅Diminished defenses
Chronic disease
Severity of infection
Renal status
Liver function
type of microorganisms ✅Gram positive
Gram negative
Aerobic
Anaerobic
Treatment Considerations:Dosage/duration ✅Adequate dosage
Adequate length of therapy
Therapy failure
Too small a dose
Too short a time period
May cause remission or exacerbation
May cause development of resistance to therapy
General nursing implications ✅Monitor for therapeutic effects
,Improvement of signs and symptoms of infection
Return to normal vital signs
Negative culture and sensitivity tests
Disappearance of fever, lethargy, drainage, and redness
Monitor for adverse reactions
patient teaching ✅Take full course of medication
DON'T STOP because you feel better!
Take evenly spaced doses
Never share or save medication
Inform of adverse drug reactions
Inform of drug-drug interactions
Inform of food-drug interactions
common side effects: GI ✅Nausea
Vomiting
Diarrhea
Nursing implications ✅Assess drug allergies; renal, liver, and cardiac function; and
other lab studies
Obtain thorough patient health history, including immune status
Assess for conditions that may be contraindications to antibiotic use or that may indicate
cautious use
Assess for potential drug interactions
safety first ✅Check the name of the medication carefully because there are many
drugs that sound alike or have similar spellings.
If giving an antibiotic as an injection (IM, IV) ALWAYS monitor 15 - 30 minutes after
injection for anaphylactic reactions
watch out ✅Each class of antibiotics has specific adverse effects and drug interactions
that must be carefully assessed and monitored
All oral antibiotics are absorbed better if taken with at least 6 to 8 ounces of water
sulfonamides ✅Take with 2000 to 3000 mL of fluid/24 hr
Assess RBCs prior to beginning therapy
Take oral doses with food
Often combined with other antibiotics
Sulfamethoxazole combined with trimethoprim (a nonsulfonamide antibiotic)
Bactrim, Septra, or co-trimoxazole (SMX-TMP)
, penicillins ✅Penicillins
Amoxicillin
MANY drug-drug interactions!
Assess for cephalosporins allergy; may have cross allergy
Take oral doses with water (not juices) as acidic fluids may nullify drug's antibacterial
action
Monitor patients taking penicillin for an allergic reaction for at least 30 minutes after
administration
cephalosporins ✅Cephalosporins - generations
ceftriaxone (Rocephin)
Assess for penicillin allergy; may have cross allergy
Give orally administered forms with food to decrease GI upset, even though this will
delay absorption
Some of these drugs may cause a disulfiram (Antabuse)-like reaction when taken with
alcohol
macrolides ✅Azithromycin (Zithromax)
These drugs are highly protein-bound and will cause severe interactions with other
protein-bound drugs
The absorption of oral erythromycin is enhanced when taken on an empty stomach, but
because of the high incidence of GI upset, many drugs are taken after a meal or snack
Avoid milk products, iron preparations, antacids, and other dairy products because of
the chelation and drug-binding that occurs
Should not be used in children under age 8 or in pregnant/lactating women because
tooth discoloration will occur if the drug binds to the calcium in the teeth
Take all medications with 6 to 8 ounces of fluid, preferably water
Because of photosensitivity, avoid sunlight and
tanning beds
ototoxicity ✅Temporary or permanent hearing loss, balance problems
Nephrotoxicity ✅Varying degrees of reduced renal function
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