Nokea
When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin. What possible effect may occur as the result of an interaction between these drugs?
- A. The penicillin will cause an enhanced anticoagulant effect of the warfarin.
- B. The penicillin will cause the anticoagulant effect of the warfarin to decrease.
- C. The warfarin will reduce the anti-infective action of the penicillin.
- D. The warfarin will increase the effectiveness of the penicillin.
Correct Answer: A
Rationale: Administering penicillin reduces the vitamin K in the gut (intestines); therefore, enhanced anticoagulant effect of warfarin may occur.
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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.
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.
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 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.