ATI Pharmacology Made Easy 4.0 Infection PDF

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8/8/2021

ATI Pharmacology Made Easy 4.0 Infection Flashcards | Quizlet tical Sciences

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Terms in this set (25) Azithromycin/Erythromycin. Rationale: Azithromycin, a macrolide, is an acceptable alternative to penicillin for patients who have bacterial infections and are allergic to penicillin. The medication is effective against many A nurse is caring for a client who has

gram-positive and gram-negative bacteria and is used for

streptococcal pharyngitis and an allergy

streptococcal pharyngitis.

to penicillin. The nurse should recognize that which of the following drugs can be

- Nafcillin and amoxicillin/clavulanic acid are penicillins and are

safely administered to this client?

contraindicated for those w/a penicillin allergy. Vancomuycin and clindamycin are safer alternatives. - A small percentage of clients who are allergic to penicillin have a cross sensitivity to cephalosporins. Cephalexin is a cephalosporin and is an inappropriate choice for the client.

Stop the cefotetan infusion. Rationale: The nurse should stop the infusion, remove the IV catheter, assess for tissue damage, and treat the client accordingly. The nurse should then initiate IV access via another site, continuing cefotetan therapy according to prescribed parameters. A nurse is administering cefotetan IV to a client to treat an intra-abdominal infection. The nurse notes that the IV insertion site is warm, edematous, and painful to the touch. Which of the following actions should the nurse take?

- Because the client could have thrombophlebitis, slowing the infusion will not alleviate the potential tissue damage or risk of embolus, and the IV site should be changed. To prevent thrombophlebitis, the nurse should dilute cefotetan, a secondgeneration cephalosporin, and infuse it slowly over 20 to 30 min. - The edematous, painful, and warm IV insertion site does not indicate an allergic reaction. The nurse should administer an antihistamine, such as diphenhydramine, if the client has hives, a rash, or other indications of an allergy to cephalosporins. - Switching the client to another antibiotic is essential when the

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Renal impairment. Rationale: Aztreonam, a monobactam, requires cautious use with clients who have renal dysfunction because it is excreted in the A nurse is caring for a client who has a

urine. Renal impairment could affect the excretion of aztreonam,

new prescription for aztreonam to treat

allowing the level of the drug to accumulate. The nurse should

a respiratory tract infection. Which of the

report this finding to the provider, so the provider can prescribe a

following findings in the client's medical

lower dose for the client or prescribe a different antimicrobial

record should the nurse recognize as

drug.

requiring cautious use for this rx and report to the provider?

- Contraindicated in those with a viral infection, used cautiously in older adults. - Metronidazole is an antimicrobial drug that req's cautious use in those with HF.

A nurse is providing teaching for a client

Use additional/non-hormonal form of contraception, as the drug

who takes an oral contraceptive and is

can increase the metabolism of oral contraceptives.

about to begin rifampin therapy to treat TB. Which of the following instructions should the nurse include?

Cefotetan + Metronidazole Rationale: Cefotetan, a second-generation cephalosporin, can cause a reaction similar to what disulfiram causes when clients consume alcohol. This reaction manifests as nausea, severe A nurse is caring for a client who has a

vomiting, headache, weakness, and hypotension. Metronidazole,

gynecologic infection and a hx of

an antiparasitic drug, can cause a reaction similar to what

alcohol use disorder. The nurse should

disulfiram causes when clients consume alcohol. This reaction

identify that which of the following drugs

manifests as nausea, severe vomiting, headache, weakness, and

can cause a rxn similar to disulfiram if the

hypotension.

client drinks alcohol while taking it? SATA.

Does not: - Nitrofurantoin (urinary tract antiseptic) can cause diarrhea, N/V. - Amoxicillin (penicillin) can cause diarrhea, N/V. - Aztreonam (a monobactum) can cause a superinfection with Candida albicans

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Dehydration Rationale: Acyclovir, an antiviral drug, can cause renal toxicity, A nurse is caring for a client who is about

especially in clients who are dehydrated. Hydration during and

to begin receiving acyclovir IV to treat a

after IV infusion of the drug can help prevent crystalluria.

viral infection. The nurse should recognize that cautious use of the drug

Drugs to use cautiously for other options:

is essential if the client also has which of

- HF: metronidazole (antiparasitic)

the following conditions?

- Asthma: amoxicillin - Tinnitus: vancomycin (antimicrobial)

Superinfection. A nurse in a provider's office receives a

Rationale: Imipenem, a carbapenem, can cause the superinfection

call from a client who was recently

Candida albicans in the mouth, throat, or vagina. It can also cause

hospitalized and treated with imipenem

glossitis, an inflammation or infection of the tongue. Clients taking

IV for a bacterial infection and reports

the drug should report any mouth pain or vaginal discharge and

an inability to eat due to mouth pain. The

itching because they might require treatment with an antifungal

nurse should identify that the client

drug.

might be experiencing which of the following as an adverse effect of this

- Unlikely to cause malabsorption, but can cause gastroenteritis,

drug?

abdominal pain, and vomiting; unlikely to cause anorexia or dental caries.

Ethacrynic acid or furosemide (Lasix), as they are loop diuretics and ototoxic drugs. Concurrent use increases the client's risk for hearing loss. A nurse is reviewing a client's prescriptions prior to administering

Others:

gentamicin to the client to treat a

- Amphotericin B (antifungal) increases risk for nephrotoxicity.

systemic infection. The nurse should

- NSAIDs (ex: ibuprofen) inc risk of nephrotoxicity.

clarify the use of gentamicin with the

- Vancomycin (antimicrobial) increases risk of ototoxicity.

provider if the client is taking which of the following drugs?

Drugs that do not specifically interact w/gentamicin: - Diphenhydramine - Acetaminophen - Levothyroxine

When administering oral erythromycin to a client who has acute diphtheria, a nurse should monitor for which of the following adverse effects?

Cardiac dysrhythmias, as the drug can cause ECG changes, such as a prolonged QT interval. Report palpitations, fainting, and dizziness. Other effects include fever, hearing loss, and diarrhea.

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Bleeding. Rationale: Trimethoprim/sulfamethoxazole, a sulfonamide combination, can increase the effects of warfarin and increase the client's risk for bleeding. The nurse should request another A nurse is caring for a client who is

prescription to treat the infection, or, if the client decides to take

taking warfarin and has a new rx for

the drug, ask the provider to prescribe a lower warfarin dose and

trimethoprim/sulfamethoxazole to treat

monitor prothrombin time carefully. The client should report any

a UTI. The nurse should clarify the

sign of bleeding, such as easy or unexplained bruising.

prescriptions w/the provider b/c taking these two drugs concurrently can

Other options and rationales:

increase the client's risk for which of the

- Thrombosis: rifampin decreases warfarin levels and inc risk of

following?

thrombosis - ECG changes: erythromycin - Ototoxicity: erythromycin + gentamicin

A nurse is caring for a client whose

Vancomycin

sputum culture results indicate methicillin-resistant MRSA. The nurse should recognize that which of the following medications will likely be administered to this client?

Jaundice, numbness of the hands, and dizziness. Rationale: Isoniazid, an antimycobacterial drug, can cause liver toxicity, especially in clients who abuse alcohol. The nurse should A nurse is caring for a client who is about to begin taking isoniazid to treat TB. The nurse should instruct the client to report which of the following adverse effects of the drug?

monitor liver enzymes during therapy and instruct the client to report indications of liver damage, such as jaundice, abdominal pain, and fatigue. The nurse should instruct the client to report numbness, pain, or tingling in the hands or feet. Administering pyridoxine (vitamin B6) can help minimize these effects. Isoniazid can cause dizziness, ataxia, and seizures. The nurse should instruct the client to report these CNS effects. - Also: visual disturbances and dry mouth.

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Isoniazid (INH). A nurse is caring for a client who has a

Rationale: Isoniazid is used to treat tuberculosis and reduces the

prescription for rifampin to treat TB. The

possibility of resistance to rifampin when combined with the drug.

nurse should expect the provider to

Drug resistance can develop quickly if the client only takes

prescribe which of the following drugs

rifampin.

to the client to prevent possible resistance to rifampin?

- Gentamicin, vancomycin, and metronidazole are not used to treat TB.

A health care professional is caring for a

Seizure disorder.

patient who is about to begin taking

Rationale: Metronidazole, an antiparasitic drug, can cause ataxia,

metronidazole (Flagyl) to treat an

vertigo, and seizures. It requires cautious use with clients who

anaerobic intra-abdominal bacterial

have a history of seizure activity, liver or renal failure, or heart

infection. The health care professional

failure.

should recognize that cautious use of the drug is indicated if the patient also

- Hearing loss: vancomycin

has which of the following?

- Asthma: amoxicillin

a. seizure disorder

- Anemia: Amphotericin B

b. hearing loss c. asthma d. anemia

A nurse is caring for a client who is about

Urine output.

to begin gentamicin therapy to treat an

Rationale: Gentamicin, an aminoglycoside, can cause

infection. The nurse should monitor the

nephrotoxicity. The nurse should monitor the client's BUN and

client for an alteration in which of the

creatinine levels and for an increased output of diluted urine. It is

following:?

also essential to monitor serum gentamicin levels and maintain a

A. Bowel function

therapeutic range.

B. Peripheral pulses C. Urine output

- Can also cause N/V, hypotension, hypertension, vertigo, and

D. LOC

skeletal muscle weakness.

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A health care professional is caring for a

Cough.

patient who is about to begin taking

Rationale: Nitrofurantoin, a urinary tract antiseptic, can cause

nitrofurantoin (Macrodantin) to treat a

cough, shortness of breath, chest pain, and fever. These adverse

urinary tract infection. The health care

effects can indicate an acute allergic reaction and require

professional should tell the patient to

immediate discontinuation of drug therapy.

report which of the following adverse effects of the drug?

- Can also cause diarrhea and peripheral neuropathy.

A. Constipation

- Dark colored urine is harmless effect.

B. Dark brown urine C. Cough D. Tremors

A nurse in a provider's office receives a

C. diff-associated diarrhea.

call from a patient who is taking

Rationale: Severe diarrhea, often containing mucus and blood, can

tetracycline orally to treat a chlamydia

indicate Clostridium difficile-associated diarrhea. Treatment

infection and reports severe blood-

includes stopping drug therapy and replacing fluids and

tinged diarrhea. The nurse should

electrolytes. Clients should immediately report severe diarrhea

suspect the client is experiencing which

and blood in the stools.

of the following? A. Hemorrhoids B. C. diff-associated diarrhea C. Diverticular disease D. Small bowel obstruction

Take an antacid at least 2 hr after taking the drug. Rationale: The nurse should recommend that the client take an A nurse in a provider's office receives a

antacid to relieve the dyspepsia at least 2 hr after taking

call from a client who is taking

ciprofloxacin, a fluoroquinolone. This is because antacids

ciprofloxacin to treat a respiratory tract

decrease the absorption of the drug.

infection and reports dyspepsia. Which of the following instructions should the

- Avoid caffeine b/c it can increase CNS effects.

nurse give the client?

- Avoid taking supplemental iron b/c iron dec absorption of drug. - Avoid taking drug w/milk or other dairy products b/c calcium decreases absorption.

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A nurse is preparing to administer

Acetaminophen + diphenhydramine.

amphotericin B IV to a patient who has a

Rationale: Infusion reactions to amphotericin B IV, such as fever,

systemic fungal infection. Which of the

chills, nausea, and headache, start 1 to 2 hr after the infusion

following drugs should the health care

begins and subside within 4 hr. The nurse can help prevent these

professional administer prior to the

effects by administering acetaminophen prior to the infusion. The

infusion to prevent or minimize adverse

nurse can help prevent adverse reactions by administering

reactions during amphotericin B

diphenhydramine prior to the infusion.

administration? (Select all that apply.) A. Aspirin

- Aspirin inc risk of renal injury.

B. Hydrocortisone

- Hydrocortisone decreases client's resistance to infection.

C. Acetaminophen

- Ibuprofen inc risk of renal injury.

D. Diphenhydramine E. Ibuprofen

A nurse is caring for a patient who is

Tendon pain.

taking ciprofloxacin (Cipro) to treat a

Rationale: Ciprofloxacin, a fluoroquinolone, can cause tendon

urinary tract infection and has

rupture, most often of the Achilles tendon. This adverse effect is

rheumatoid arthritis, for which he takes

especially common for older adults or clients who take

prednisolone (Prelone). Recognizing the

glucocorticoids, such as prednisolone. The nurse should tell the

adverse effects of ciprofloxacin, the

client to report tendon pain and stop taking the drug.

health care professional should tell the patient to report which of the following?

- Can also cause photosensitivity and vertigo, malaise.

A. Tachycardia B. Hair loss C. Insomnia D. Tendon pain

A nurse in a provider's office receives a

"Bring in a stool sample for testing."

call from a client who has been taking penicillin V 3x daily and reports

- The nurse cannot make changes to client's prescription, the client

abdominal cramping w/bloody diarrhea

should not self-treat diarrhea, and blood work is not indicated for

for several days. Which of the following

these symptoms.

instructions should the nurse give the client?

A patient who is taking amoxicillin to treat a respiratory infection contacts the health care professional to report a rash and wheezing. Which of the following instructions should the nurse provide?

Call emergency services immediately. Rationale: Amoxicillin can cause a severe anaphylactic reaction. A client who has difficulty breathing should call emergency services and seek immediate care. The client will need to be treated with epinephrine and an antihistamine, such as diphenhydramine, to treat an anaphylactic reaction.

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Swelling of hands or feet, or gynecomastia. Rationale: Itraconazole, an azole antifungal drug, can cause A nurse is caring for a client who is about

edema, which can also indicate heart dysfunction, and should be

to begin taking itraconazole to treat a

monitored closely. It can also cause a temporary decrease in

fungal infection. The nurse should

sexual hormone synthesis, resulting in gynecomastia, reduced

instruct the client to report which of the

libido, low sperm counts, and menstrual irregularities.

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