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The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?
- A. First-generation
- B. Second-generation
- C. Third-generation
- D. Fourth-generation
Correct Answer: A
Rationale: First-generation cephalosporins provide excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria.
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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 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.
The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which statement by the nurse is correct?
- A. Avoid direct sunlight and tanning beds while on this medication.
- B. Milk and cheese products result in increased levels of tetracycline.
- C. Antacids taken with the medication help to reduce gastrointestinal distress.
- D. Take the medication until you are feeling better.
Correct Answer: A
Rationale: Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for several days after therapy. Milk and cheese products result in decreased levels of tetracycline when the two are taken together. Antacids also interfere with absorption and should not be taken with tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if they feel that they are no longer ill.
A patient with a long-term intravenous catheter is going home. The nurse knows that if the patient is allergic to seafood, which antiseptic agent is contraindicated?
- A. Chlorhexidine gluconate
- B. Hydrogen peroxide
- C. Povidone-iodine
- D. Isopropyl alcohol
Correct Answer: C
Rationale: Iodine compounds are contraindicated in patients with allergies to seafood.
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.