Before You Give It
A patient is prescribed IV gentamicin. Which laboratory value is most important for the nurse to review before administration?
Serum creatinine / renal function
A patient receiving gentamicin reports new ringing in the ears. What adverse effect should the nurse suspect?
Ototoxicity.
A patient prescribed doxycycline plans to spend the weekend at the beach. What teaching should the nurse provide?
Limit sun exposure and use protective clothing and sunscreen because doxycycline can cause photosensitivity.
A patient with influenza asks why amoxicillin was not prescribed. What is the best explanation?
Amoxicillin targets bacterial cell-wall synthesis; influenza is caused by a virus
A patient receiving an antibiotic suddenly develops wheezing, facial swelling, and hypotension. What is the nurse's priority?
Stop the medication, activate emergency assistance, and ensure prompt IM epinephrine per protocol.
A patient with suspected bacterial sepsis has orders for blood cultures and IV antibiotics. Which action should the nurse perform first, provided it will not significantly delay treatment?
Obtain the ordered blood cultures.
A patient taking clindamycin develops frequent watery diarrhea and abdominal cramping. What complication should the nurse suspect?
Clostridioides difficile infection.
A patient taking rifampin reports that their urine has turned orange-red. What is the appropriate nursing response?
Explain that orange-red discoloration of body fluids is an expected medication effect.
A patient has an infection caused by a bacterium susceptible to penicillin. Which bacterial structure is targeted by amoxicillin?
The bacterial cell wall
A patient taking antibiotics reports severe watery diarrhea. What should the nurse do?
Assess the patient, initiate appropriate infection-control precautions when indicated, and notify the provider for evaluation of possible C. difficile.
A patient is prescribed oral doxycycline. Which medication in the patient's morning routine could decrease its absorption?
An antacid containing calcium or magnesium (also iron supplements).
During a vancomycin infusion, a patient develops flushing and itching of the face and upper body without respiratory compromise or hypotension. What infusion-related reaction should the nurse consider?
Vancomycin infusion reaction.
A patient is prescribed oral nystatin suspension for oral candidiasis. Which instruction helps ensure the medication contacts the affected tissue?
Swish the suspension throughout the mouth before swallowing or spitting, as directed.
A patient is prescribed oseltamivir for influenza. Which viral process does this medication inhibit?
Release of newly formed influenza viruses through neuraminidase inhibition
A patient's bacterial culture shows that the organism is resistant to the prescribed antibiotic. What should the nurse do?
Notify the prescriber and clarify the antimicrobial treatment plan.
A patient is prescribed IV vancomycin. Which laboratory values should the nurse monitor to assess for nephrotoxicity?
Serum creatinine and other measures of renal function.
A patient receiving ciprofloxacin reports sudden pain and swelling near the Achilles tendon. What serious adverse effect should the nurse suspect?
Tendinitis or tendon injury, with risk of tendon rupture.
A patient prescribed oral doxycycline asks how to prevent irritation of the esophagus. What should the nurse teach?
Take the medication with a full glass of water and remain upright afterward.
A patient with a fungal infection is prescribed ketoconazole. Which component of the fungal cell membrane does this medication interfere with producing?
Ergosterol
A patient receiving IV gentamicin develops decreased urine output and a rising serum creatinine. What is the priority nursing action?
Hold the next dose pending prompt prescriber evaluation, assess renal function, and clarify the treatment plan.
A patient taking linezolid also takes sertraline. What potentially serious medication interaction should the nurse recognize?
Increased risk of serotonin syndrome
A patient taking isoniazid for tuberculosis reports numbness and tingling in the hands and feet. What adverse effect should the nurse suspect?
Peripheral neuropathy
A patient taking rifampin uses oral hormonal contraceptives. What important teaching should the nurse provide?
Rifampin can decrease the effectiveness of hormonal contraceptives. Discuss an appropriate alternative or additional contraceptive method.
A patient is prescribed acyclovir for a herpes infection. What process does this medication inhibit?
Viral DNA synthesis
A patient receiving IV amphotericin B develops a potassium level of 2.7 mEq/L. What is the nurse's priority?
Recognize severe hypokalemia, promptly notify the provider, assess cardiac status, and anticipate potassium replacement and reassessment of therapy