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The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
- A. Increased red blood cell count
- B. Increased hemoglobin level
- C. Decreased white blood cell count
- D. Decreased platelet count
Correct Answer: C
Rationale: Decreased white blood cell counts are an indication of reduction of infection and are a therapeutic effect of antibiotic therapy.
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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 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.
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 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.