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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 Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial.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.
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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 monitoring a client who is receiving penicillin. The nurse would assess the client for which of the following common GI tract adverse reactions? Select all that apply.
- A. Glossitis
- B. Stomatitis
- C. Esopliagitis
- D. Diarrhea
- E. Gastritis
Correct Answer: A,B,D,E
Rationale: A nurse monitoring a client taking penicillin should be aware of the common GI tract adverse reactions, including glossitis, stomatitis, gastritis, nausea, vomiting, diarrhea, and abdominal pain.
A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins. The nurse determines that the teaching was successful when the patient identifies which of the following? Select all that apply.
- A. Drowsiness
- B. Headache
- C. Constipation
- D. Heartburn
- E. Vomiting
Correct Answer: B,D,E
Rationale: Common adverse reactions to cephalosporins include nausea, vomiting, diarrhea, headache, dizziness, malaise, heartburn, and fever.
When performing an ongoing assessment of a client receiving amoxicillin (Amoxil), the nurse should monitor the client for which of the following? Select all that apply.
- A. Relief of symptoms
- B. Development of a rash
- C. Increase in appetite
- D. Change in appearance or amount of drainage
- E. Decrease in temperature
Correct Answer: A,C,D,E
Rationale: An ongoing assessment is important in evaluating the client's response to therapy, such as a decrease in temperature, relief of symptoms caused by the infection, an increase in appetite, and a change in the appearance and amount of drainage.
While administering vancomycin IV to a patient, the nurse suspects that the patient is developing redeman syndrome based on assessment of which of the following? Select all that apply.
- A. Headache
- B. Throbbing neck pain
- C. Chills
- D. Erythema of the neck and back
- E. Difficulty breathing
Correct Answer: B,C,D
Rationale: Red-man syndrome is manifested by a decrease in blood pressure, occurrence of throbbing neck or back pain, fever, chills, paresthesias, and erythema of the neck and back. Headache is unrelated to this syndrome. Difficulty breathing might suggest an anaphylactic reaction.