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A patient is admitted with a fever of 102.8?°F (39.3?°C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence?
- A. Blood culture, antibiotic dose, urine culture
- B. Urine culture, antibiotic dose, blood culture
- C. Antibiotic dose, blood and urine cultures
- D. Blood and urine cultures, antibiotic dose
Correct Answer: D
Rationale: All culture specimens should be obtained before initiating antibiotic drug therapy; otherwise, the presence of antibiotics in the tissues may result in misleading culture and sensitivity results.
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A patient tells the nurse that he is having nausea and decreased appetite during drug therapy with a tetracycline antibiotic. Which statement is the nurse's best advice to the patient?
- A. Take it with cheese and crackers or yogurt.
- B. Take each dose with a glass of milk.
- C. Take an antacid with each dose as needed.
- D. Drink a full glass of water with each dose.
Correct Answer: D
Rationale: Oral doses should be given with at least 8 ounces of fluids and food to minimize gastrointestinal upset. Antacids and dairy products will bind with the tetracycline and make it inactive.
During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by which of these?
- A. Large doses of antibiotics that kill normal flora
- B. The infection spreading from the lungs to the new site of infection
- C. Resistance of the pneumonia-causing bacteria to the drugs
- D. An allergic reaction to the antibiotics
Correct Answer: A
Rationale: Normally occurring bacteria are killed during antibiotic therapy, allowing other flora to take over and resulting in superinfections.
The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?
- A. First-generation
- B. Second-generation
- C. Third-generation
- D. Fourth-generation
Correct Answer: A
Rationale: First-generation cephalosporins provide excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria.
During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)
- A. Wheezing
- B. Diarrhea
- C. Shortness of breath
- D. Swelling of the tongue
- E. Itching
- F. Black, hairy tongue
Correct Answer: A,C,D,E
Rationale: Hypersensitivity reactions may be manifested by wheezing; shortness of breath; swelling of the face, tongue, or hands; itching; or rash. Diarrhea and black, hairy tongue are not typically associated with hypersensitivity reactions but may be other side effects of antibiotic therapy.
A patient will be having oral surgery and has received an antibiotic to take for 1 week before the surgery. The nurse knows that this is an example of which type of therapy?
- A. Empiric
- B. Prophylactic
- C. Definitive
- D. Resistance
Correct Answer: B
Rationale: Prophylactic antibiotic therapy is used to prevent infection. Empiric therapy involves selecting the antibiotic that can best kill the microorganisms known to be the most common causes of an infection. Definitive therapy occurs once the culture and sensitivity results are known. Resistance is not a type of antibiotic therapy.