Nokea
A group of nursing students are reviewing information about administering penicillins. The students demonstrate an understanding of the information when they identify which drugs as being given without regard to meals? Select all that apply.
- A. Amoxicillin (Amoxil)
- B. Ampicillin (Principen)
- C. Penicillin V (Veetids)
- D. Amoxicillin/clavulanate (Augmentin)
- E. Carbenicillin indanyl (Geocillin)
Correct Answer: A,C
Rationale: Amoxicillin and penicillin V can be administered without regard to meals, unlike the rest of the penicillins, such as ampicillin, amoxicillin/clavulanate, or carbenicillin indanyl, which should be given on an empty stomach.
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A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions would be most appropriate for the nurse to do when preparing penicillin in parenteral form?
- A. Extract penicillin from vial and then reconstitute.
- B. Save excess antibiotic after reconstitution for later use.
- C. Use any available diluent for reconstitution.
- D. Shake the vial well to distribute the drug evenly.
Correct Answer: D
Rationale: When preparing a parenteral form of penicillin, the nurse should shake the vial thoroughly before withdrawing the drug to ensure its even distribution in the solution. Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial. Excess antibiotic after reconstitution should never be saved, as the drug loses its potency when stored. Reconstitution should be done only with the diluent prescribed on the manufacturer's label.
A nurse is preparing to administer penicillin therapy. The nurse would expect to administer penicillins cautiously to clients with which of the following? Select all that apply.
- A. History of allergies
- B. Diabetes
- C. Asthma
- D. Bleeding disorders
- E. Hypertension
Correct Answer: A,C,D
Rationale: Penicillins should be used cautiously in clients with renal disease, asthma, bleeding disorders, GI disease, pregnancy or lactation, and a history of allergies.
A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation?
- A. Instruct patient to increase dietary intake.
- B. Inform the primary health provider immediately.
- C. Record assessments on patient's chart.
- D. Inquire about any previous drug allergies.
Correct Answer: C
Rationale: When the patient declares that he is feeling better and is also showing improved health, it should be recorded on the patient's chart. If the condition of the patient has improved, the patient will show an increased appetite, but there is no need to instruct the patient to increase dietary intake. The primary health provider need not be informed about the condition immediately unless the patient shows signs of deterioration or complications. The nurse should inquire about previous drug allergies before the start of therapy.
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.
Before administering the first dose to the client, which assessment should the nurse perform as part of the preadministration assessment?
- A. Review of renal and hepatic function tests
- B. Inspection of patient's stools
- C. Evaluation of patient's lifestyle and diet
- D. General history of patient's health
Correct Answer: D
Rationale: Before administering the first dose of penicillin, the nurse should obtain and review the patient's general health history, including any allergy history, a history of all medical and surgical treatments, a drug history, and the current symptoms of the infection. The patient's stool is examined only after penicillin has been administered if the patient has diarrhea. It is not required to evaluate the patient's lifestyle and diet as part of the preadministration assessment for the first dose. Renal and hepatic function tests may be performed at intervals during penicillin therapy, usually not before it.