Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents

You know that penicillins are more effective when used on what type of bacteria? Gram-negative viruses Gram-positive bacteria Gram-negative bacteria Fungal infections - Gram-positive bacteria Explanation: Clinical indications for use of penicillins include bacterial infections caused by susceptible microorganisms. As a class, penicillins usually are more effective in infections caused by gram-positive bacteria than those caused by gram-negative bacteria. However, their clinical uses vary significantly according to the subgroup or individual drug and microbial patterns of resistance. Your client receives IV vancomycin every 12 hours. You know that this infusion should run over: 1 to 2 hours. 3 to 4 hours. 2 to 4 hours. 30 minutes. - 1 to 2 hours. Explanation: For systemic infections, vancomycin is given IV and reaches therapeutic plasma levels within 1 hour after infusion. It is very important to give IV infusions slowly, over 1 to 2 hours, to avoid an adverse reaction characterized by hypotension, flushing, and skin rash. This reaction, sometimes called "red man syndrome," is attributed to histamine release. A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? Serum BUN and creatinine levels Complete blood count Coagulation studies Signs of disulfiram-like reaction - Serum BUN and creatinine levels Explanation: The nurse would need to assess renal function indicated by serum BUN and creatinine levels because combining cephalosporins with aminoglycosides increases the client's risk for renal toxicity. Coagulatio