Nokea
A patient is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: D
Rationale: Each IV dose of vancomycin is infused over 60 minutes. Too rapid an infusion may result in a sudden and profound fall in blood pressure and shock.
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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 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 Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial.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.
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.
Which of the following should be included in the nurse's preadministration assessment prior to administering a penicillin to a client? Select all that apply.
- A. Allergy history
- B. Medical history
- C. Medication history
- D. Blood glucose levels
- E. Current symptoms
Correct Answer: A,B,C,E
Rationale: An allergy history, medical and surgical history, medication history, and the current symptoms of the infection should be included in the nurse's preadministration assessment prior to a client receiving a penicillin.
A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform?
- A. Inspect mouth and gums regularly.
- B. Instruct patient to avoid brushing teeth.
- C. Offer patient a liquid diet.
- D. Instruct the patient to gargle every 2 hours.
Correct Answer: A
Rationale: The nurse should regularly inspect the patient's mouth and gums to assess the patient's progress. The nurse should instruct the patient to use a soft-bristled toothbrush. The patient need not follow a liquid diet; a nonirritating soft diet can be recommended. Gargling every 2 hours may not help relieve the symptoms and may even aggravate the existing condition.