Principles of Antimicrobial Therapy
Narrow vs Broad Spectrum
Which one treats a few types of bacteria?
Narrow
How long does the nurse stay with the client after parenteral administration?
30 minutes
A nurse administers doxycycline. What are the complications of this medication?
Hepatotoxicity
Yellow or brown tooth discoloration
Identify adverse effects of Trimethoprim-sulfamethoxaolne
Stevens-Johnson sydrome
Crystalluria
Kernicterus in new borns
What are the 2 medications used for TB?
Isoniazid
Rifampin
Which medication is used to treat herpes simplex and varicella-zoster (shingles)?
Acyclovir
Where should IM immunizations be administered for infants and young children?
Vastus lateralis or ventrogluteal
Which chemotherapy drug IS NOT toxic to bone marrow?
Vincristine
The provider orders furosemide 80 mg PO daily. The pharmacy supplies furosemide in 40 mg tablets. How many tablets should the nurse administer?
80 mg / 40 mg = 2 tablets
Lab testing
Gram stain and culture
What two medication antibiotics have a cross-sensitivity for allergies?
Penicillins and Cephalosporins
When administering a Tetracycline, why should the nurse educate the patient to sit up for 30 minutes after medication administration?
A nurse administers Nitrofurantoin. What harmless color of urine can the client expect?
rust-yellow to brownish urine
A client is on Isoniazid. What should the nurse administer to prevent/treat peripheral neuropathy? How much should the nurse administer?
Vitamin B6 - 50 to 200 mg
Ganciclovir
Where should IM immunizations be administered for adults?
Deltoid muscle
A patient receives Methotrexate at a high dose. What is the antidote?
Leucovorin
The order is for amoxicillin 250 mg PO. The oral suspension is labeled 125 mg/5 mL. How many mL should the nurse administer?
250 mg / 125mg = 2
2 x 5 = 10
Answer: 10 mL
What are the host factors for the selection process for an antimicrobial?
Site of infection
Age
Pregnancy
Allergies
Cephalosporins:
Where should the nurse store oral suspensions?
refrigerator
What should the nurse monitor when administering Erythromycin?
Monitor ECG. This medication can cause prolonged QT intervals.
Monitor for ototoxicity with high-dose therapy.
What is a major adverse effect of Ciprofloxacin?
Achilles tendon rupture
Rifampin can turn body fluids to which color? What are considered bodily fluids?
Urine, saliva, sweat, and tears can turn red-orange color
What is Highly Active Antiretroviral Therapy (HAART) used for?
reduce amount of virus and increase CD4 counts.
What ages is the DtaP vaccine given?
2, 4, 6, 15-18 months and 4-6 years
A nurse is providing education to a client on Methotrexate. What can the client use to prevent bleeding?
Soft toothbrush
Electric razor
A pediatric patient weighing 22 lbs is ordered acetaminophen 15 mg/kg. The concentration available is 160 mg/5 mL. How many mL should the nurse administer?
22lb = 10kg
10 x 15 = 150mg total dose
150 / 160 x 5 = 4.7
Answer: 4.7
Sensitivity of an antimicrobial
Colitis
Oral Thursh
Black furry overgrowth on the tongue
Vaginal yeast infection
Ototoxicity
Nephrotoxicity
A nurse is educating a client taking Levofloxacin. What should the nurse include?
Avoid dairy, antacids, iron, and calcium while taking medication.
Encourage 1,500 to 2,000 mL daily fluid
Metallic taste
Darkening of urine (harmless)
CNS effects (dizziness, seizures, peripheral neuropathy)
What age is the annual influenza vaccine recommended?
Starting at 6 months
A nurse administers Doxorubicin. What harmless side effect can occur to the patient?
Red urine and tears for up to 2 days.
The nurse is preparing to administer 1,000 mL of 0.9% Normal Saline over 8 hours. What is the infusion rate in mL/hr?
Identify preventative measures to avoid infection
Hand hygiene
Ensuring up-to-date immunizations
Taking all antimicrobials
Utilizing infection-control procedures
A nurse administers vancomycin. How should this medication be administered? What complications should the nurse look out for?
Infuse slowly over 60 minutes.
Complications: ototoxicity, nephrotoxicity and Red Man Syndrome
Given IM or IV
Peak: 30 min after administration
Trough: right before next dose
What harmless color of urine should the client expect to see when taking Phenazopyridine? What education should the nurse provide for this side effect?
Orage-red color urine is normal.
It can stain clothes and contact lenses.
Complications: infusion reaction, thrombophlebitis, nephrotoxicity, bone marrow suppression.
Infused slowly over 4-6 hours IV.
Pre-treat with diphenhydramine
What age is the Meningococcal (MenACWY/MenB) vaccine recommended?
11 to 12 years old
A client is prescribed Tamoxifen for breast cancer. What are complications of this medication?
Endometrial cancer
DVT/PE/Stroke
Hot flashes
Vaginal discharge and bleeding
An IV of D5W 500 mL is ordered to infuse over 4 hours. The drop factor is 15 gtt/mL. What is the flow rate in gtt/min? (Round to the nearest whole number).
Convert 4 Hrs = mins (240 mins)
500 / 240 = 2.08
2.08 x 15 = 31.2
Answer: 31