NR 293 Final Exam 3 (2023/2024) Verified Questions and Answers

NR 293 Final Exam 3 (2023/2024) Verified Questions and Answers bacteriostatic drugs that do not kill the bacteria, but slows their growth culture and sensitivity take a blood culture so we can determine where the bacteria is growing; sensitivity report determines the best treatment antibiotic combos Additive potentiative antagonisitic empiric therapy treatment of an infection before specific culture information has been obtained definitive therapy antibiotic therapy tailored to treat organisms identified with cultures prophylactic therapy treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma MOA of sulfonamides Bacteriostatic inhibit bacterial growth prevent bacterial synthesis of folic acid uses of sulfonamides Gramp positive and negative, broad spectrum respiratory tract infections infections of the small bowel UTIs: enterobacter, ecoli, klebsiella, proteus vulgaris, staphylococcus aureus contraindications of sulfonamides drug allergy pregnant women infants younger than 2 months potassium oral contraceptives (ineffective) Adverse effects of sulfonamides mild to moderate rash photosensitivity GI distress stomatitis crystalluria fatigue depression headache dizziness blood dyscrasias Steven Johnsons syndrome renal failure hyperkalemia prototype for sulfonamides, and administration sulfamethoxazole combined with trimethropim Administered IV, PO, Topical patient education/ nursing interventions for sulfonamides Pt. Education: take with a full glass of water increase fluid intake report sore throat, bruising, bleeding avoid direct sunlight Nursing interventions: push fluids Monitor CBC signs of bleeding (liver damage) check for superinfection beta lactam penicilins MOA safest class bacteriocidal inhibition of bacterial cell wall synthesis uses of penicillins strep staph pneumonia meningitis skin, bone, and joint infections stomach infections blood and valve infections gas gangrene tetanus anthrax sickle cell anemia in infants broad spectrum penicillin bacteriocidal ecoli salmonella influenza adverse effects of penicillin allergy most common rash pruritus fever anaphylaxis lowered WBC, RBC, platelet count GI upset patient education for penicillins side effects bleeding increase fluid intake take with food drugs for penicillin broad spectrum: amoxicillin combination: piperacillin plus tazobactam (zosyn) give 3 times a day infused over 4 hours or every 6 hours infused over 1 hour cephalosporins MOA largest class interfere with bacterial cell wall synthesis, bind to the same penicillin binding proteins uses of cephalosporins treatment of gram positive and negative anaerobic bacteria mostly gram negative patients who cannot tolerate the less expensive penicillins respiratory infections urinary infections skin infections bone and joint infections genital infections contraindications of cephalosporins may cause cross allergy potential with penicillin adverse effects of cephalosporins weakness pruritus GI distress high doses can cause bleeding seizures nephrotoxicity patient education of cephalosporins side effects administration monitor kidney function with 1st generation drugs for cephalosporins first generation Cefazolin (ancef) not effective for beta lactase gram positive bacteria may cause kidney toxicity macrolides MOA broad spectrum inhibit protein synthesis binds reversibly to 50S ribosomal subunits of microbes uses of macrolides whooping cough legionnaires disease Hpylori streptococcus influenza mycoplasma pneumonia generic use: respiratory GI tract skin soft tissue adverse effects of macrolides tinnitus ototoxicity mild GI distress diarrhea abdominal pain superinfectionm hepatotoxicity patient education/ nursing interventions Patient education: finish full regimen monitor hepatic function food-drug interactions (fruit juices) take on empty stomach Nursing interventions: monitor hepatic function bleeding, bruising, dark tea looking urine, jaundice drugs for macrolides we do not need peak or troughs for Azithromycin (Zithromax, Zpack) only take for 5 days due to its long half life administer antacids 2 hours before or after on an empty stomach with full glass of water tetracyclines MOA broad spectrum inhibit protein synthesis uses of tetracyclines acne Rocky Mountain spotted fever typhus cholera lymes disease peptic ulcers Hpylori contraindications of tetracyclines drug allergy children under 8 pregnancy category D, fetal growth/develeopment milk antacids iron decrease effect of oral contraceptives increases effect of digoxin adverse effects of tetracycline discoloration of teeth retard fetal skeletal development if taken during pregnancy photsensitivity alteration of intestinal and vaginal flora reversible bulging fontanelles in neonates thrombocytopenia heolytic anemia hepatotoxicity (IV or high doses) nephrotoxicity (outdated meds) GI distress patient education of tetracyclines use sunblock store out of light/heat good oral hygeine food-drug interactions labs administration times drugs for tetracyclines tetracycline (achromycin) administer 1-2 hours after meals aminoglycosides MOA prevent protein synthesis in bacteria uses of aminoglycosides serious gram negative bacteria: ecoli serratia proteus psuedomonas mycobacteria some protozoans common category to treat klebsiella combined with penicillin, cephalosporins, or vancomycin for enterococcal infections may be given to sterilize bowel prior to surgery contraindications for aminoglycosides renal patients adverse effects of aminoglycosides nephrotoxicity ototoxicity: hearing impairment dizzy loss of balance persistant headache ringing in ears possible deaf superinfection photosensitivity anaphylaxis GI distress rash patient education/nursing interventions for aminoglycosides Pt. education monitor hearing use sunblock lab work nursing interventions monitor drug levels monitor serum levels drugs for aminoglycosides gentamicin (garamycin) if GI can not absorb, give IV give deep into leg muscle IM withhold if peak levels are above normal range