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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.
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After teaching a group of nursing students about the different generations of cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a first-generation cephalosporin? Select all that apply.
- A. Cefepime (Maxipime)
- B. Cefazolin (Ancef)
- C. Cefoxitin (Mefoxin)
- D. Cephalexin (Keflex)
- E. Cefaclor (Raniclor)
Correct Answer: B,D
Rationale: Cefazolin and cephalexin are examples of first-generation cephalosporins. Cefoxitin and cefaclor are examples of second-generation cephalosporins. Cefepime is an example of a fourth-generation cephalosporin.
A nurse is conducting an in-service training program for a group of nurses about antibacterial drugs such as penicillins and cephalosporins. During the question-and-answer period, the audience asks for examples of conditions that can be treated by cephalosporins. Which of the following would the nurse include in the response?
- A. Hemolysis
- B. Urinary tract infections
- C. Nausea and diarrhea
- D. Jaundice
Correct Answer: B
Rationale: Cephalosporins are used to treat respiratory infections, otitis media, urinary tract infections, and bone and joint infections, and prophylactically to treat infections that may result from a sexual assault. Cephalosporins are not used to treat hemolysis or jaundice. Nausea and diarrhea are some of the adverse reactions that can occur when a patient is on cephalosporin therapy.
After teaching a group of students about antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the students identify which of the following as an example of a carbapenem? Select all that apply.
- A. Vancomycin
- B. Imipenem-cilastatin
- C. Meropenem
- D. Aztreonam
- E. Ceftriaxone
Correct Answer: B,C
Rationale: Carbapenems include imipenem-cilastatin and meropenem. Vancomycin and aztreonam are classified as miscellaneous drugs that disrupt the bacterial cell wall. Ceftriaxone is a third-generation cephalosporin.
While the nurse is obtaining a drug history from a patient, the patient tells the nurse that he is allergic to penicillins and has also experienced a rash when he took a cephalosporin. The nurse interprets this information as indicating which of the following?
- A. Hypersensitivity
- B. Cross-sensitivity
- C. Anaphylactoid reaction
- D. Anaphylaxis
Correct Answer: B
Rationale: Once an individual is allergic to one penicillin, he or she is usually allergic to all of the penicillins. Those allergic to penicillin also have a higher incidence of allergy to the cephalosporins. Allergy to drugs in the same or related groups is called cross-sensitivity. Hypersensitivity is an allergic reaction to one substance. Anaphylactoid reaction is an unusual or exaggerated allergic reaction. Anaphylaxis or anaphylactic shock is a severe form of hypersensitivity that occurs immediately and can be fatal.
A group of nursing students are reviewing information about administering penicillins. The students demonstrate an understanding of the information when they identify which drugs as being given without regard to meals? Select all that apply.
- A. Amoxicillin (Amoxil)
- B. Ampicillin (Principen)
- C. Penicillin V (Veetids)
- D. Amoxicillin/clavulanate (Augmentin)
- E. Carbenicillin indanyl (Geocillin)
Correct Answer: A,C
Rationale: Amoxicillin and penicillin V can be administered without regard to meals, unlike the rest of the penicillins, such as ampicillin, amoxicillin/clavulanate, or carbenicillin indanyl, which should be given on an empty stomach.