NSG203 Unit 9 Study Guide Exam
what are the adverse effects of sulfonamides? - Answer - allergic reaction is typically a
delayed cutaneous reaction (fever, rash)
- photosensitivity: can result in severe sunburn
- other: GI upset (N/V, diarrhea, pancreatitis, hepatotoxicity), hematologic (anemia,
thrombocytopenia)
what is beta-lactam antibiotics? - Answer - penicillins
- inhibit enzymes that can inactivate penicillin antibiotics
- combination products of penicillins and beta-lactamase inhibitors
(ampicillin/sulbactam-unasyn)
- effective against gram-positive
- little if ant ability against gram-negative with the exception of extended-spectrum
(pipercillin/tazobactam-zosyn)
what is amoxicillin and ampicillin? - Answer - beta-lactam antibiotics penicillins
- amoxicillin: used to treat infections in the ears, nose, throat, GU, skin and skin
structures; can be given with or without food and its available in PO form
- ampicillin: am[icillin anhydrous and ampicillin trihydrate given PO, ampicillin sodium is
given parenterally, and combination of ampicillin and sulbactam (unasyn) is most
commonly used
what are the interactions to penicillin? - Answer - methotrexate: increase methotrexate
levels
- NSAIDs: increase the amount of free and active penicillin
- oral contraceptives: decreased efficacy of contraceptive
- warfarin: enhanced anticoagulant effect
what is nursing care related to administration of antiinfectives? - Answer - non-HIV
antivirals: use appropriate technique when administering (wear gloves when applying
ointments to prevent spread of disease)
- administer oral meds with meals to help minimize GI upset
- take medication for the entire course of therapy (if a dose is missed, take as soon as
possible)
- IV acyclovir is stable for 12 hours at room temp but will precipitate if refrigerated
, (infuse over at least an hr to prevent renal damage, increase fluids to help protect
kidneys, monitor IV site closely, doc. characteristics of lesions, implement appropriate
isolation for chickenpox or herpes zoster)
- HIV antivirals (antiretrovirals): follow any admin. and handling guidelines, film-coated
oral dosage forms (do not alter the drug), evenly space doses around the clock to
maintain blood levels, and administer with food unless contraindicated (indinacir)
what are the interactions to gentamicin? - Answer - concurrent use of other nephrotoxic
drugs
- concurrent use of loop diuretics increases the r/f ototoxicity
- warfarin: can potentiate warfarin activity
what is client education for quinolones? - Answer - take for the full course of treatment
- do not administer with antacids, iron, zinc, multivitamins, or sucralfate
- educate about photosensitivity
what is the nurse care of a client on vancomycin? - Answer - blood levels must be
monitored bc its nephrotoxic and ototoxic
- labs: liver function, kidney function, urinalysis, EKG, culture and sensitivity, CBC,
assess for superinfection
- assess trough levels: generally done before the 4th dose
- assess for "red man syndrome": flushing of the face, head, neck, and trunk associated
with an infucision rate that is too rapid
- assess BP as hypotension can develop with a rapid infusion
- there are many IV incompatibilities
- do not infuse any faster than 60 mins
- monitor IV site closely d/t extravasation
- monitor for nephrotoxicity, neurotoxicity, ototoxicity, superinfections
- adequate hydration: at least 2000 mL/day unless contraindicated
what is the nursing care of a client on metronidazole? - Answer - inquire about alcohol
intake
- neurologic assessment: dizziness, numbness, tingling
- GI assessment: bowel sounds, patterns
- GU assessment: patterns, color of urine, I&O
what are the adverse effects of sulfonamides? - Answer - allergic reaction is typically a
delayed cutaneous reaction (fever, rash)
- photosensitivity: can result in severe sunburn
- other: GI upset (N/V, diarrhea, pancreatitis, hepatotoxicity), hematologic (anemia,
thrombocytopenia)
what is beta-lactam antibiotics? - Answer - penicillins
- inhibit enzymes that can inactivate penicillin antibiotics
- combination products of penicillins and beta-lactamase inhibitors
(ampicillin/sulbactam-unasyn)
- effective against gram-positive
- little if ant ability against gram-negative with the exception of extended-spectrum
(pipercillin/tazobactam-zosyn)
what is amoxicillin and ampicillin? - Answer - beta-lactam antibiotics penicillins
- amoxicillin: used to treat infections in the ears, nose, throat, GU, skin and skin
structures; can be given with or without food and its available in PO form
- ampicillin: am[icillin anhydrous and ampicillin trihydrate given PO, ampicillin sodium is
given parenterally, and combination of ampicillin and sulbactam (unasyn) is most
commonly used
what are the interactions to penicillin? - Answer - methotrexate: increase methotrexate
levels
- NSAIDs: increase the amount of free and active penicillin
- oral contraceptives: decreased efficacy of contraceptive
- warfarin: enhanced anticoagulant effect
what is nursing care related to administration of antiinfectives? - Answer - non-HIV
antivirals: use appropriate technique when administering (wear gloves when applying
ointments to prevent spread of disease)
- administer oral meds with meals to help minimize GI upset
- take medication for the entire course of therapy (if a dose is missed, take as soon as
possible)
- IV acyclovir is stable for 12 hours at room temp but will precipitate if refrigerated
, (infuse over at least an hr to prevent renal damage, increase fluids to help protect
kidneys, monitor IV site closely, doc. characteristics of lesions, implement appropriate
isolation for chickenpox or herpes zoster)
- HIV antivirals (antiretrovirals): follow any admin. and handling guidelines, film-coated
oral dosage forms (do not alter the drug), evenly space doses around the clock to
maintain blood levels, and administer with food unless contraindicated (indinacir)
what are the interactions to gentamicin? - Answer - concurrent use of other nephrotoxic
drugs
- concurrent use of loop diuretics increases the r/f ototoxicity
- warfarin: can potentiate warfarin activity
what is client education for quinolones? - Answer - take for the full course of treatment
- do not administer with antacids, iron, zinc, multivitamins, or sucralfate
- educate about photosensitivity
what is the nurse care of a client on vancomycin? - Answer - blood levels must be
monitored bc its nephrotoxic and ototoxic
- labs: liver function, kidney function, urinalysis, EKG, culture and sensitivity, CBC,
assess for superinfection
- assess trough levels: generally done before the 4th dose
- assess for "red man syndrome": flushing of the face, head, neck, and trunk associated
with an infucision rate that is too rapid
- assess BP as hypotension can develop with a rapid infusion
- there are many IV incompatibilities
- do not infuse any faster than 60 mins
- monitor IV site closely d/t extravasation
- monitor for nephrotoxicity, neurotoxicity, ototoxicity, superinfections
- adequate hydration: at least 2000 mL/day unless contraindicated
what is the nursing care of a client on metronidazole? - Answer - inquire about alcohol
intake
- neurologic assessment: dizziness, numbness, tingling
- GI assessment: bowel sounds, patterns
- GU assessment: patterns, color of urine, I&O
