#vaccines4life
Name that type of immunity: When the body receives antibodies from another source, temporary/short-acting immunity, immunity is granted immediately, ex: immune serums!
Passive Immuity
A patient, curious about the Penicillin that was prescribed for an ear infection, asks the nurse how this medication will treat the infection. What is the correct response?
Binds to and disrupts the bacterial cell wall to allow leakage of intracellular contents and kill bacteria via lysis.
A patient is having a hysterectomy and is in need of their pre-surgical medications. Which order would you expect to see?
Cefuroxime (Zinacef)
Ceftriaxone (Rocephin)
Cefazolin (Ancef)
Ceftaroline (Teflaro)
1. Cefuroxime (Zinacef)
What are first-line treatments for latent & active TB?
Rifampin, Isoniazid (INH), Pyrazinamide, Ethambutol
John, a 62-year-old patient, is seen in the clinic for complaints of indigestion and heartburn after eating. The physician informs John of over the counter antacid medications, such as Magnesium-Calcium (Rolaids) to take to relieve the heartburn. What is important to educate John on when taking this type of medication with others?
Antacids prevent absorption of most drugs, separate administration by 1-2 hours.
Laurie, a 29-year-old pregnant patient, presents to the clinic for a 36 week follow-up. We discuss her needs for vaccinations prior to labor. Which order from the physician would you question?
Tetanus (Tdap) IM injection
Influenza IM Injection
Measles, Mumps, Rubella (MMR) Subq Injection
Covid-19 IM Injection
3. MMR SQ Injection
Your female patient, who has Asthma, is taking a corticosteroid for maintenance and treatment of this chronic condition. What signs and symptoms should we monitor for when prescribing an antibiotic to this patient during a week-long hospital admission?
Yellow or white patches of the mouth, abnormal vaginal discharge, extremely watery diarrhea, etc.
As the nurse, your patient receiving Vancomycin via IV is showing signs of hypotension, a red rash across the face and down the torso, itching, and an elevated heart rate. What do you do first as the nurse?
STOP THE INFUSION!!!!!
For a patient with Tuberculosis, what education would you provide regarding Rifamycins, specifically?
May cause red-orange discoloration of tears, urine, and sweat, decreases effectiveess of OCP, monitor liver and kidney functions
A patient is prescribed Diphenoxylate with Atropine (Lomotil) for severe diarrhea. What are important nursing considerations for this medication?
Not used for diarrhea caused by infection of ingestion of toxic materials, assess for respiratory depression!
A patient arrives for their yearly wellness check at the clinic. He is due for vaccinations. What factor would be a contraindication to receiving the HPV vaccination?
Immunocompromization
Temperature of 102.3
Hypercoagulability
HIV infection
Your patient with an Upper Respiratory Infection informs you of an allergy to Penicillin. What medication would you expect the PCP to prescribe this patient?
Cephalexin (Keflex)
Meropenem (Merrem)
Amoxicillin
Clindamycin (Cleocin)
4. Clindamycin (Cleocin)
Sara, an avid volleyball player, reports pain and swelling of the tendon in her ankle. You see that she was seen in Urgent Care a few days ago for an Upper Respiratory Infection and was prescribed Ciprofloxacin. What is Sara experiencing?
Tendon Rupture!
An 18-year-old patient arrives at the clinic with feeling unwell and a temperature of 102.3. A rapid test shows a positive Flu A test. A provider prescribes Oseltamivir (Tamiflu). What is important to educate the patient on?
Reduces symptoms and duration of infection, start within 48 hours, not a cure, side effects include: nausea, vomiting, diarrhea, conjunctivitis, and epistaxis.
After one-year of taking Pantoprazole (Protonix), Jane, an 82 year old patient, is seen in the clinic. As her nurse, what should you assess for with long-term use of Proton Pump Inhibitors?
Magnesium deficiencies, increased risk of C. Diff, vitamin B12 deficiency, Hypocalcemia (osteoporosis)
Joe, your patient on the MedSurg floor of the local hospital, is complaining that every nurse he has keeps asking if he wants a Flu vaccine. He exclaims, “I already got vaccinated in 2019! Why do you keep asking me?” As his new nurse, what would you inform him of?
The flu virus mutates frequently, vaccines are based on predictions of the next year's viral strain, we urge people to continue yearly vaccines to prevent infection!
After receiving the results of the culture and sensitivity test for your patient, you note that the bacteria is resistant to the empiric therapy of Amoxicillin due to beta-lactamases. Which medication would you expect the PCP to switch the patient to? (select all that apply)
Ampicillin
Amoxicillin-clavulanate (Augmentin)
Penicillin
Dicloxacillin
Piperacillin-tazobactam (Zosyn)
Amoxicillin
5. Zosyn
List a few of the unique side effects/contraindications for patients taking Tetracycline (Achromycin)?
Yellow/brown discoloration of teeth, contraindicated <8 years old/pregnancy/renal failure, hearing loss, photosensitivity, epigastric pain, OCP interactions, shortened bone growth
Why are a combination of antiretroviral drugs of preferred for viral suppression and what should we monitor while the patient is taking these?
Fewer side effects and increased adherence, CD4+ cell count & adverse effects
A patient is seen in the clinic after taking a medication for a Gastric Ulcer for the past 6 weeks. They are not sure what the name of the actual medication is, but they do know it is a Histamine Receptor Antagonist. The patient reports symptoms of confusion and gynecomastia. Knowing this, what medication do you anticipate they are taking?
Cimetidine (Tagamet)
Laurie, now 32 weeks pregnant, comes to the Emergency Room after being bitten by a rabid animal. The nurse is preparing to administer the Rabies Immunoglobulin Immune Serum as an injection. What education should be provided?
1. Signs of DVT
2. Only temporary immunity, need another immune serum if you are bitten again!
Right before your patient is taken to the emergency room for an Open Reduction Internal Fixation (ORIF) of the right tibia, you anticipate administering which Cephalosporin to the patient?
Ceftriaxone (Rocephin)
Cefuroxime (Zinacef)
Ceftaroline (Teflaro)
Cefazolin (Ancef)
Jerry was discharged yesterday from the hospital with his antibiotic. He returned to the ER early this evening with flushing, headaches, nausea, vomiting, and chest pain. As the nurse, seeing the medications he has taken, what question would you first ask?
"Have you consumed any alcohol recently?"
List a few major nursing considerations for the treatment of TB with RIPE:
Medication adherence with DOT therapy, monitor liver function Q2 during initial 8 weeks of therapy, airborne precautions until 3 successive negative sputum cultures
A patient with Rheumatoid Arthritis must take an NSAID to relieve associated pain. With a concern for ulcer development, the Physicians prescribe Misoprostol (Cytotec) to aid in prevention. What information from the patient’s chart would cause pause in administering this medication?
History of headaches
Recent nausea and vomiting
20 weeks gestational age
Fluid and electrolyte imbalance from diarrhea
3. 20 weeks gestational age