Nokea
Which of the following should be included in the nurse's preadministration assessment prior to administering a penicillin to a client? Select all that apply.
- A. Allergy history
- B. Medical history
- C. Medication history
- D. Blood glucose levels
- E. Current symptoms
Correct Answer: A,B,C,E
Rationale: An allergy history, medical and surgical history, medication history, and the current symptoms of the infection should be included in the nurse's preadministration assessment prior to a client receiving a penicillin.
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A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation?
- A. Instruct patient to increase dietary intake.
- B. Inform the primary health provider immediately.
- C. Record assessments on patient's chart.
- D. Inquire about any previous drug allergies.
Correct Answer: C
Rationale: When the patient declares that he is feeling better and is also showing improved health, it should be recorded on the patient's chart. If the condition of the patient has improved, the patient will show an increased appetite, but there is no need to instruct the patient to increase dietary intake. The primary health provider need not be informed about the condition immediately unless the patient shows signs of deterioration or complications. The nurse should inquire about previous drug allergies before the start of therapy.
A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient?
- A. Monitoring fluid intake
- B. Monitoring blood creatinine levels
- C. Testing for occult blood
- D. Testing for increased glucose levels
Correct Answer: B
Rationale: An elderly patient is more susceptible to the nephrotoxic effects of the cephalosporins. Since renal impairment is present, it is important for the nurse to closely monitor the patient's blood creatinine levels. The nurse should conduct a test for occult blood if blood and mucus occur in the stool and monitor the fluid intake if there is a decrease in urine output. The nurse does not need to monitor for increased glucose levels unless the patient has a history of diabetes.
After taking penicillin as prescribed, a patient shows signs of diarrhea and informs the nurse that there is blood in his stools. Which of the following interventions should the nurse do next?
- A. Contact primary health provider immediately.
- B. Have the patient consume yogurt with his next meal.
- C. Decrease fiber content in diet.
- D. Continue with prescribed regimen.
Correct Answer: A
Rationale: If diarrhea is suspected, the nurse should notify the primary health care provider immediately. The nurse should wait for the primary health care provider's instructions before continuing with the prescribed regimen. Yogurt or buttermilk may help prevent fungal superinfections, but they will not help alleviate the patient's condition at this stage. Changes in the diet are not recommended unless instructed by the primary health care provider.
A nursing instructor is preparing a class about cephalosporins for a group of nursing students. When describing progression from first-generation to fourth-generation cephalosporins, which of the following would the instructor include as the result? Select all that apply.
- A. An increase in the sensitivity of gram-negative microorganisms
- B. A decrease in the sensitivity of gram-negative microorganisms
- C. An increase in the sensitivity of gram-positive microorganisms
- D. A decrease in the sensitivity of gram-positive microorganisms
- E. An increase in the sensitivity of viral microorganisms
Correct Answer: A,D
Rationale: In general, progression from first-generation to fourth-generation cephalosporins shows an increase in the sensitivity of gram-negative microorganisms and a decrease in the sensitivity of gram-positive microorganisms.
The nurse is obtaining a medication history of a 48-year-old patient with an ear infection who is to receive penicillin therapy. The patient reports taking a beta-adrenergic blocker for his hypertension. The nurse would identify that this patient is at increased risk for which of the following if penicillin is administered?
- A. Anaphylactic shock
- B. Higher blood pressure
- C. Excess bleeding
- D. Heart attack
Correct Answer: A
Rationale: Combining penicillins with beta-adrenergic blocking drugs increases the risk of anaphylactic shock. Beta-adrenergic blocking drugs are used to control blood pressure and heart problems, but combining them with penicillins does not increase the risk of high blood pressure or heart attack. Risk of bleeding is maximized if penicillins are combined with anticoagulants.