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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.
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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 group of students are reviewing information about the different penicillins. The students demonstrate understanding of the information when they identify which of the following as an example of a beta-lactamase inhibitor? Select all that apply.
- A. Piperacillin
- B. Amoxicillin
- C. Tazobactam
- D. Sulbactam
- E. Clavulanic acid
Correct Answer: C,D,E
Rationale: Examples of beta-lactamase inhibitors are clavulanic acid, sulbactam, and tazobactam. Amoxicillin is an example of an aminopenicillin. Piperacillin is an example of an extended-spectrum penicillin.
While administering vancomycin IV to a patient, the nurse suspects that the patient is developing redeman syndrome based on assessment of which of the following? Select all that apply.
- A. Headache
- B. Throbbing neck pain
- C. Chills
- D. Erythema of the neck and back
- E. Difficulty breathing
Correct Answer: B,C,D
Rationale: Red-man syndrome is manifested by a decrease in blood pressure, occurrence of throbbing neck or back pain, fever, chills, paresthesias, and erythema of the neck and back. Headache is unrelated to this syndrome. Difficulty breathing might suggest an anaphylactic reaction.
A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins. The nurse determines that the teaching was successful when the patient identifies which of the following? Select all that apply.
- A. Drowsiness
- B. Headache
- C. Constipation
- D. Heartburn
- E. Vomiting
Correct Answer: B,D,E
Rationale: Common adverse reactions to cephalosporins include nausea, vomiting, diarrhea, headache, dizziness, malaise, heartburn, and fever.
The nurse administers cefuroxime to a patient at least 1 hour before meals, as prescribed. However, the patient experiences GI upset. Which of the following would be most appropriate for the nurse to do?
- A. Administer an antacid.
- B. Lower the dosage.
- C. Discontinue the drug.
- D. Administer the drug with food.
Correct Answer: D
Rationale: If the patient experiences GI upset, the nurse can administer cefuroxime with food. A decrease in the dosage is suggested in a patient with renal impairment. A change in dosage, discontinuation of the drug, or use of an antacid is recommended only if prescribed by the physician.