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A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report that he is feeling anxious and is having trouble breathing. What will the nurse do first?
- A. Notify the prescriber.
- B. Take the patient's vital signs.
- C. Stop the antibiotic infusion.
- D. Check for allergies.
Correct Answer: C
Rationale: Hypersensitivity reactions are characterized by wheezing; shortness of breath; swelling of the face, tongue, or hands; itching; or rash. The nurse should immediately stop the antibiotic infusion, have someone notify the prescriber, and stay with the patient to monitor the patient's vital signs and condition. Checking for allergies should have been done before the infusion.
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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 preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?
- A. Antiseptics are used to sterilize surgical equipment.
- B. Disinfectants are used as preoperative skin preparation.
- C. Antiseptics are used only on living tissue to kill microorganisms.
- D. Disinfectants are used only on nonliving objects to destroy organisms.
Correct Answer: D
Rationale: Antiseptics primarily inhibit microorganisms but do not necessarily kill them. They are applied exclusively to living tissue. Disinfectants are able to kill organisms and are used only on nonliving objects.
The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.)
- A. Opioids
- B. Oral contraceptives
- C. Sulfonylureas
- D. Antihistamines
- E. Phenytoin
- F. Warfarin
Correct Answer: B,C,E,F
Rationale: Sulfonamides may potentiate the hypoglycemic effects of sulfonylureas in diabetes treatment and the toxic effects of phenytoin. They also enhance the anticoagulant effects of warfarin, which can lead to hemorrhage. Sulfonamides may also reduce the efficacy of oral contraceptives. Opioids and antihistamines are not typically associated with significant interactions with sulfonamides.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101?°F (38.3?°C). Based on these findings, which conclusion will the nurse draw?
- A. The patient's original infection has not responded to the antibiotic therapy.
- B. The patient is showing typical adverse effects of antibiotic therapy.
- C. The patient needs to be tested for Clostridium difficile infection.
- D. The patient will need to take a different antibiotic.
Correct Answer: C
Rationale: Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a serious superinfection when it causes antibiotic-associated colitis, also known as pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever.
A patient will be receiving penicillin G potassium, 12 million units daily in divided doses every 4 hours IVPB. Identify how many units the patient will receive for each dose each day.
Correct Answer: 2 million
Rationale: If a medication is given every 4 hours, then there will be 6 doses in each 24-hour day. (24 ?· 4 = 6). 12 million units ?· 6 doses = 2 million units/dose.