Nokea
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.
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A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?
- A. Macrolides
- B. Carbapenems
- C. Sulfonamides
- D. Tetracyclines
Correct Answer: C
Rationale: Sulfonamides achieve very high concentrations in the kidneys, through which they are eliminated. Therefore, they are often used in the treatment of urinary tract infections.
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.
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
- A. Tetracyclines
- B. Sulfonamides
- C. Cephalosporins
- D. Quinolones
Correct Answer: C
Rationale: Allergy to penicillin may also result in hypersensitivity to cephalosporins. Patients reporting penicillin allergy need to describe their prior allergic reaction. It is very important to document the type of reaction.
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.
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.