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A client is prescribed penicillin therapy to treat an infection. Which of the following would the nurse include in the teaching plan for the client to reduce her risk of fungal superinfections? Select all that apply.
- A. Yogurt can sometimes help.
- B. Try drinking some buttermilk.
- C. You could take Acidophilus capsules.
- D. Rinse your mouth daily with an alcohol-based mouthwash.
- E. Use a soft-bristle toothbrush when brushing.
Correct Answer: A,B,C,E
Rationale: The nurse can recommend that, if the diet permits, yogurt, buttermilk, or Acidophilus capsules may be taken to reduce the risk of fungal superinfection. Also, brushing with a soft-bristle toothbrush and frequent mouth care with a nonirritating solution can be helpful.
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After teaching a group of students about antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the students identify which of the following as an example of a carbapenem? Select all that apply.
- A. Vancomycin
- B. Imipenem-cilastatin
- C. Meropenem
- D. Aztreonam
- E. Ceftriaxone
Correct Answer: B,C
Rationale: Carbapenems include imipenem-cilastatin and meropenem. Vancomycin and aztreonam are classified as miscellaneous drugs that disrupt the bacterial cell wall. Ceftriaxone is a third-generation cephalosporin.
The nurse administers cefuroxime to a patient at least 1 hour before meals, as prescribed. However, the patient experiences GI upset. Which of the following would be most appropriate for the nurse to do?
- A. Administer an antacid.
- B. Lower the dosage.
- C. Discontinue the drug.
- D. Administer the drug with food.
Correct Answer: D
Rationale: If the patient experiences GI upset, the nurse can administer cefuroxime with food. A decrease in the dosage is suggested in a patient with renal impairment. A change in dosage, discontinuation of the drug, or use of an antacid is recommended only if prescribed by the physician.
A nurse needs to administer a cephalosporin to a patient. The patient informs the nurse that he is allergic to penicillin. Which action by the nurse would be most appropriate?
- A. Inform the primary health care provider.
- B. Obtain the patient's occupational history.
- C. Administer an antipyretic drug.
- D. Obtain specimens for kidney function tests
Correct Answer: A
Rationale: Patients with a history of an allergy to penicillin may also be allergic to cephalosporin, so the nurse needs to inform the primary health care provider before the first dose of the drug is given. An antipyretic drug is administered when there is an increase in the body temperature of a patient receiving cephalosporin. Liver and kidney function tests may be ordered by the primary health care provider, not the nurse. Occupational history should be obtained before administration of any drug, irrespective of the patient's allergies.
A 26-year-old female patient with a skin infection has been prescribed 400 mg ampicillin to be taken orally. Which of the following instructions should the nurse include in the patient teaching plan?
- A. If a dosage is missed, increase the next dosage to meet the daily quota.
- B. Ampicillin will reduce the effectiveness of birth control pills.
- C. Take drug on an empty stomach, an hour before or 2 hours after meals.
- D. Avoid use of skin care products, like moisturizers, when on penicillin therapy.
Correct Answer: B
Rationale: Ampicillin (also penicillin V) reduces the effectiveness of birth control pills. Increasing a dosage to compensate for a missed dosage should not be done. The patient should adhere to the prescribed regimen as strictly as possible. Ampicillin and penicillin V may be taken without regard to meals. The patient need not avoid use of skin care products when on penicillin therapy.
A nurse is caring for a patient who is receiving penicillin. The nurse would assess for which of the following as a common adverse reaction?
- A. Inflammation of the tongue and mouth
- B. Impaired oral mucous membranes
- C. Severe hypotension
- D. Sudden loss of consciousness
Correct Answer: A
Rationale: Some of the common adverse effects of penicillin are glossitis (inflammation of the tongue), stomatitis (inflammation of the mouth), and gastritis (inflammation of the stomach). Unless the adverse effects are severe, the drug may be continued as prescribed and the nurse would intervene to help the patient manage the common adverse reactions. Impaired oral mucous membranes would suggest a possible fungal superinfection in the oral cavity, whereas severe hypotension and sudden loss of consciousness are signs of anaphylactic shock; these are not common adverse effects of penicillin and require immediate medical attention.