NSG 511 Exam 3
broad spectrum - answer capability of attacking many different types of bacteria
narrow spectrum - answer effective against less types of bacteria
Bactericidal - answer kills bacteria
Bacteriostatic - answer slows the growth of bacteria
Super infection - answer new infection that occurs during tx for primary infection
common in hospital settings
occur when use more broad spectrum abx and increases risk with length of time, hard
to tx
(eg Cdiff, ESBL, MRSA, Candida)
Preventing Resistance - answer hand hygiene, PPE, vaccinations, proper use, effective
dx and tx
How to select the right antimicrobial - answermatch the drug with the bug
culture or use empiric therapy (best guess pathogen for the location of the infection,
most likely bug if cant get a sample)
when culture get gram stain and see what its senstive to for a tx
use the most narrow one as possible
must consider host age, immunocompromised, site of infection, foreign devices,
breastfeeding/pregnant, allergies, genetic factors
when are cases for using 2 antimicrobials - answerHIV, severe infection like TB
why is it rare to use a bactericidal with bacteriostatic - answerrarely beneficial because
static ones stop the growth of the bacteria and cidals kill activley growing bacteria so it
does not work synergistically
different mechanisms of antimicrobials - answerinhibit cell wall synthesis or disrupt cell
wall/increase permeabilty-PCN, Cephalsporins, Vanc
Inhibit protein synthesis- Tetracycline and Erythromycin
Inhibit or disrupt DNA- Ciprofloxacin
Antimetabolites (folate acid synthesis)- TMP-SMP and Macrobid/Nitrofuratoin
, nursing considerations for infections - answerobtain a sample for culture before giving
abx and then provide best guess abx until cultures come back and may need to switch
the abx
assess for isolation precautions
targeted assessments for patients
targeted assessments for patients depending on age and condition - answerkids-ears
and tonsils
young adults- STD and acne
older adults - UTI and pneumonia
Hospitalized- HAIs, loss primary defenses by tubes, drains, and surgical incision
Immunocompromised- cancer tx or leukemia and AIDS
Nursing considerations for Antimicrobials - answertake full dose, dont skip or stop,
report allergies and SA that could increase noncompliance, skin reactions and
respiratory symptoms are priority
can increase bleeding tendencies (fall risk older adults) due to warfarin interactions and
vit K decreased absorption by decreasing gut bacteria to do job
allergic reactions- GI, Hives, anaphylaxis,
careful of peak and trough levels before administration, rate of infusion, timing of doses
and kidney and liver fx
pan culture - answerculturing everything, not sure where the infection is
sputum, urine, stool, everything
culture and sensitivity - answergrowing microorganisms in isolation in order to
determine which drugs it might respond to
Nursing considerations for infections - answerobtain culture before giving abx, laster-
targeted assessment, instructions (take full dose, don't skip), many abx have bleeding
tendencies
Penicillin MOA - answerbinds to PBPs and disrupts rigid cell wall allowing fluid to be
drawn in
Methicillin-resistant Staphylococcus aureus (MRSA) - answermutates penicillin binding
proteins so they are unable to be bound to
Penicillin is structurally related to - answerCephalosporins-- Beta Lactams
Penicillin spectrum - answerboth narrow and broad depending on drug, gram positive
more than negative due to that extra outer layer on negative
how to fight PCN resistence - answersince microbes make betalactamase and enzymes
to breakdown PCN, can use combo drugs with beta lactamase inhibitors
eg Augmentin and Zosyn are combo drugs
broad spectrum - answer capability of attacking many different types of bacteria
narrow spectrum - answer effective against less types of bacteria
Bactericidal - answer kills bacteria
Bacteriostatic - answer slows the growth of bacteria
Super infection - answer new infection that occurs during tx for primary infection
common in hospital settings
occur when use more broad spectrum abx and increases risk with length of time, hard
to tx
(eg Cdiff, ESBL, MRSA, Candida)
Preventing Resistance - answer hand hygiene, PPE, vaccinations, proper use, effective
dx and tx
How to select the right antimicrobial - answermatch the drug with the bug
culture or use empiric therapy (best guess pathogen for the location of the infection,
most likely bug if cant get a sample)
when culture get gram stain and see what its senstive to for a tx
use the most narrow one as possible
must consider host age, immunocompromised, site of infection, foreign devices,
breastfeeding/pregnant, allergies, genetic factors
when are cases for using 2 antimicrobials - answerHIV, severe infection like TB
why is it rare to use a bactericidal with bacteriostatic - answerrarely beneficial because
static ones stop the growth of the bacteria and cidals kill activley growing bacteria so it
does not work synergistically
different mechanisms of antimicrobials - answerinhibit cell wall synthesis or disrupt cell
wall/increase permeabilty-PCN, Cephalsporins, Vanc
Inhibit protein synthesis- Tetracycline and Erythromycin
Inhibit or disrupt DNA- Ciprofloxacin
Antimetabolites (folate acid synthesis)- TMP-SMP and Macrobid/Nitrofuratoin
, nursing considerations for infections - answerobtain a sample for culture before giving
abx and then provide best guess abx until cultures come back and may need to switch
the abx
assess for isolation precautions
targeted assessments for patients
targeted assessments for patients depending on age and condition - answerkids-ears
and tonsils
young adults- STD and acne
older adults - UTI and pneumonia
Hospitalized- HAIs, loss primary defenses by tubes, drains, and surgical incision
Immunocompromised- cancer tx or leukemia and AIDS
Nursing considerations for Antimicrobials - answertake full dose, dont skip or stop,
report allergies and SA that could increase noncompliance, skin reactions and
respiratory symptoms are priority
can increase bleeding tendencies (fall risk older adults) due to warfarin interactions and
vit K decreased absorption by decreasing gut bacteria to do job
allergic reactions- GI, Hives, anaphylaxis,
careful of peak and trough levels before administration, rate of infusion, timing of doses
and kidney and liver fx
pan culture - answerculturing everything, not sure where the infection is
sputum, urine, stool, everything
culture and sensitivity - answergrowing microorganisms in isolation in order to
determine which drugs it might respond to
Nursing considerations for infections - answerobtain culture before giving abx, laster-
targeted assessment, instructions (take full dose, don't skip), many abx have bleeding
tendencies
Penicillin MOA - answerbinds to PBPs and disrupts rigid cell wall allowing fluid to be
drawn in
Methicillin-resistant Staphylococcus aureus (MRSA) - answermutates penicillin binding
proteins so they are unable to be bound to
Penicillin is structurally related to - answerCephalosporins-- Beta Lactams
Penicillin spectrum - answerboth narrow and broad depending on drug, gram positive
more than negative due to that extra outer layer on negative
how to fight PCN resistence - answersince microbes make betalactamase and enzymes
to breakdown PCN, can use combo drugs with beta lactamase inhibitors
eg Augmentin and Zosyn are combo drugs
