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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.
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A group of nursing students are reviewing the different groups of penicillins. The students demonstrate understanding when they identify which of the following as an example of a penicillinase-resistant penicillin? Select all that apply.
- A. Dicloxacillin
- B. Penicillin G
- C. Nafcillin
- D. Oxacillin
- E. Ampicillin
Correct Answer: A,C,D
Rationale: Dicloxacillin, nafcillin, and oxacillin are examples of penicillinase-resistant penicillins. Penicillin G is an example of a natural penicillin. Ampicillin is an example of an aminopenicillin.
After teaching a group of nursing students about penicillins, the instructor determines that the teaching was successful when the students identify which of the following as a group? Select all that apply.
- A. Synthetic penicillins
- B. Natural penicillins
- C. Penicillinase-resistant penicillins
- D. Aminopenicillins
- E. Extended-spectrum penicillins
Correct Answer: B,C,D,E
Rationale: Penicillins are categorized into four groups including the natural penicillins, penicillinase-resistant penicillins, aminopenicillins, and extended-spectrum penicillins.
A patient receiving penicillin therapy tells the nurse that she feels like her mouth is irritated and that she has a sore throat. Inspection reveals a red, swollen tongue with ulcerations. The nurse suspects a fungal superinfection and identifies which nursing diagnosis as most appropriate for this patient?
- A. Impaired Comfort
- B. Impaired Oral Mucous Membranes
- C. Deficient Knowledge
- D. Inadequate Nutrition: Less Than Body Requirements
Correct Answer: B
Rationale: The assessment suggests a fungal superinfection, which would lead to the nursing diagnosis of Impaired Oral Mucous Membranes. Although Impaired Comfort may be appropriate, Impaired Oral Mucous Membranes is more specific. There is no evidence of lack of knowledge or problems with nutrition. However, if the superinfection is not addressed, the patient may experience difficulty eating due to the irritation and discomfort.
The nurse is obtaining a medication history of a 48-year-old patient with an ear infection who is to receive penicillin therapy. The patient reports taking a beta-adrenergic blocker for his hypertension. The nurse would identify that this patient is at increased risk for which of the following if penicillin is administered?
- A. Anaphylactic shock
- B. Higher blood pressure
- C. Excess bleeding
- D. Heart attack
Correct Answer: A
Rationale: Combining penicillins with beta-adrenergic blocking drugs increases the risk of anaphylactic shock. Beta-adrenergic blocking drugs are used to control blood pressure and heart problems, but combining them with penicillins does not increase the risk of high blood pressure or heart attack. Risk of bleeding is maximized if penicillins are combined with anticoagulants.
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.