Drugs for Bacterial Infections

Precautions

100

A Patient comes in to the ER who is showing signs and symptoms of MRSA (Fever, wound drainage) what Precautions should you have for this patient and what does that precaution include?

CONTACT- private room, gloves, gown, handwashing, disposable supplies

200

A Patient has active TB but OH NO their precaution sign fell off their door!!! DO not worry, it's ok you happen to know what precaution is for tuberculosis. What does the nurse get/do to prepare to enter this patient's room?

Mask with special respirator (N-95), gloves, private room, negative air flow, handwashing

300

A patient comes into your clinic with nuchal rigidity and a fever. What precautions are you going to assign to this patient?

(meningitis) 

Droplet precautions- private room, mask, gloves, disposable supplies, handwashing

400

You are gaining a health history on a patient when you find out they tested positive for the TB skin test. After your assessment of them you see they do not have any signs or symptoms of TB. What precautions do you deem appropriate for this patient?

Standard for LTBI

500

What precautions are appropriate for a patient with chicken pox?

Airborne and contact

Nursing Implications

100

The ER is PACKED so patients are having to share rooms. Which patient should not share a room with a patient with pneumonia?

1). A patient with an Upper Respiratory Infection coughing up yellow sputum

2). A 5 post op liver transplant patient about to be discharged

3). A patient in a coma who is on a ventilator

2- because assume on immunosuppressants

200

Which patient is ok for the pregnant nurse to treat?

1).  A patient with severe C.Diff you needs a rectal tube inserted

2). A patient with chicken pox

3). A patient who thinks they have Chylamydia and needs a vaginal exam

4). A patient with Hepatitis B and needs to be prepped for surgery

1). C.Diff

The rest are part of the 

CHEAP TORCHES list of infections that are particularly harmful to pregnant women.

300

Which antibiotics are safe for pregnant people?

Erythromycin (macrolides)

Penecillan G

Cephalosporin

400

A patient come in with sign and symptoms of sepsis what should the nurse do first? (first line therapy)

Fluid Resuscitation is the first line therapy 

0.9% NaCl (maintain MAP and urine output)

Monitor/hep resp and CV function w/O2

500

HELP! you gave a patient Vancomycin 30 minutes ago with an IV push and now their skin is red with a rash on their face and neck. Their BP is 222/89. 

Since you are a good nurse you know exactly what is happening and why

the patient is experiencing Red Man Syndrome (from from pushing the drug vancomycin to fast)stop administering the drug and start diphenhydramine

SEPSISSSS

100

How often should you check the vitals of someone with sepsis

every 15 minutes (cont SPO2)

200

S/Sx of low perfusion... GO!\

(CNS, RESP, METAB, GUT, KIDN, SKIN, CVS)

CNS- aggitated/confused/coma

RESP- increased ventilation (RR)

METAB- acidosis

GUT- decreased peristalsis/ileus

KIDN- Olig/Anuria

SKIN- cyanotic/cold

CVS- Increased HR

Hyperglycemia**

300

Name the 4 steps of Sepsis

SIRS

SEPSIS

SEVERE SEPSIS

SEPTIC SHOCK

400

We need two "sirs" criteria to suspect sepsis. Name 2 (out of 4) of those criteria

high or low temp

increased respirations

HR > 90

WBC high or low

500

What are the characteristics of SEVERE SEPSIS?

What is the difference between this and SEPTIC SHOCK

HOTN <90 sys

LA > 4 (organ damage)

SEPTIC SHOCK

Diseases

100

What is the greatest risk of meningitis and what do we assess neurological changes for (looking for a specific series of sign/symptoms that are grouped together and called one umbrella term)

Greatest risk is and increase in intracranial pressure which of the brain and death

early neurological changes should be monitored to catch the development of Cushings triad (Sev HTN, widened pulse pressure, bradycardia)

200

Define: Urethritis, Cystitis, Pyelonephritis and what causes each

Urethritis- inflammation of urethra

Cystitis- inflammation of the bladder

Pyelonephritis- infection/inflammation of kidney

E.coli (UTI)

300

Your patient has C.diff. when you get their labs back what do you expect their Sodium, Potassium, Creatinine, BUN to look like

Hyponaturemia, Hypokalemia, Increased creatinine, Increased BUN (because of poor perfusion)

400

Diagnose these three patients:

1). Low grade fever, night sweats, anorexia, weight loss, fatigue, depending on location: cough, purulent, SOB, dyspnea and hemoptysis in late stages

2). Fever, chills, flank pain, CVA tenderness, sepsis if not treated

3). Fever, chills, fatigue, crackles, cough with sputum, dyspnea

TB

Pyelonephritis

Pneumonia

500

Your patient has C.Diff and has lost a lot of water. Now she is going into cardiac arrythmias. Why is this happening?

The electrolyte imbalances can cause cardiac arrythmias. (low K)

Basics

100

What is culturing a specimen and what is testing it for sensitivity?

Culturing= examination of specimen for microorgs (IDing)

Sensitivity= testing to see which antibiotics work against the microorgs

200

Your patient has signs and symptoms of a respiratory infection, while you are waiting for their sputum sample to have culture and sensitivity testing, what should you give the patient (with HCP orders)

broad spectrum antibiotics

300

What is a trough and what is a peak related to drug administration. Why do we care?

Trough- lowest conc in blood stream

Peak- highest conc in blood stream

because drugs have very narrow therapeutic windows.

400

When should we draw for a trough

30 mins before next dose (for all routes)
ALWAYS depends on the route not the drug

500

You are educating a patient about their antibiotic. What are some commonalities about all antibiotics you can start off by explaining?

Gi distress, N/V, abd pain/diarrhea, fungal/superinfections, resistance