Nokea
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.
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A nursing instructor is preparing a class about cephalosporins for a group of nursing students. When describing progression from first-generation to fourth-generation cephalosporins, which of the following would the instructor include as the result? Select all that apply.
- A. An increase in the sensitivity of gram-negative microorganisms
- B. A decrease in the sensitivity of gram-negative microorganisms
- C. An increase in the sensitivity of gram-positive microorganisms
- D. A decrease in the sensitivity of gram-positive microorganisms
- E. An increase in the sensitivity of viral microorganisms
Correct Answer: A,D
Rationale: In general, progression from first-generation to fourth-generation cephalosporins shows an increase in the sensitivity of gram-negative microorganisms and a decrease in the sensitivity of gram-positive microorganisms.
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.
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.
The nurse is providing care to a patient who is receiving an aminoglycoside for a wound infection. The patient is also ordered to receive a cephalosporin. The nurse would carefully assess the patient for which of the following?
- A. Nausea
- B. Nephrotoxicity
- C. Increased bleeding
- D. Respiratory difficulty
Correct Answer: B
Rationale: When cephalosporin is administered with aminoglycosides, it increases the risk for nephrotoxicity and should be closely monitored. Nausea is an adverse reaction of cephalosporins in patients with gastrointestinal tract infection. The risk of bleeding increases when cephalosporin is administered with oral anticoagulants. The risk for respiratory difficulty and a disulfiram-like reaction increases if alcohol is consumed within 72 hours after administration of certain cephalosporins.
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.