Quiz 3 Concepts

Question 1

What is important to know when administering meds with a narrow therapeutic index?

Answer 1

there is a limited range between the therapeutic dose and the toxic dose so serum peak and trough levels have to be monitored

Question 2

What can you do to make sure you are obtaining the most accurate culture?

Answer 2

obtain the specimen before antibiotic therapy begins

Question 3

A pt. taking antibiotics develops mouth sores. What does this indicate and what should be done?

Answer 3

this indicates a superinfection but the drug does not need to be held

Question 4

Cefazolin in high doses will increase what in a patient?

Answer 4

BUN, creatinine, AST, ALT, ALP, LDH, and bilirubin

Question 5

What occurs with the frequent use of antibiotics?

Answer 5

frequent use of antibiotics increases exposure of bacteria and increases the bacteria’s resistance to those meds

Question 6

What can occur if you skip a dose of an antibiotic?

Answer 6

skipping doses is incomplete treatment of an infection and the remaining bacteria may develop resistance

Question 7

What can happen if you treat viral infections with antibiotics

Answer 7

it can cause resistance to develop from unneeded exposure

Question 8

Macrolide

Answer 8

broad-spectrum antibacterial that treats whooping cough and Legionnaires disease
S: dysrhythmia, nausea, vomiting, diarrhea, ototoxicity
O: cardiac, GI, ear
C: proto is erythromycin, take on an empty stomach, advise the client to report palpitations, caution for pts. w/ liver or GI disorders

Question 9

What can occur when taking macrolides in high doses with other hepatotoxic drugs?

Answer 9

it can cause hepatotoxicity so liver enzymes should be monitored

Question 10

What can occur if macrolides are taking with warfarin?

Answer 10

it can increase the serum level

Question 11

Why shouldn’t tetracyclines be given to children younger than 8 years old?

Answer 11

they irreversibly discolor the teeth

Question 12

Tetracyclines

Answer 12

treat chlamydia and other gram-negative bacteria
S: nausea, vomiting, diarrhea, hepatotoxicity, suppressed bone growth
O: GI, liver, bones, integumentary
C: administer 1 hour before meals or 2 hours after but not before bedtime, caution for pregnant women and liver impairment
K: can interact with calcium and antacids, monitor for jaundice, not for pregnant women

Question 13

What can high doses of tetracyclines cause?

Answer 13

nephrotoxicity

Question 14

Gentamicin

Answer 14

an aminoglycoside that is a narrow spectrum and can treat e.coli and pneumonia, intake and output needs to be monitored for kidney function

Question 15

When taking gentamicin and the pt. notices a change in urine output, what should occur?

Answer 15

notify the provider, and obtain the serum trough levels to make sure the drug is not at a toxic level

Question 16

Aminoglycosides

Answer 16

treats e.coli and pneumonia
S: ototoxicity and nephrotoxicity
O: ear, kidney
C: proto is gentamicin, monitor for reports of tinnitus and vertigo, check I & O
K: ototoxicity is the biggest adverse effect

Question 17

Fluoroquinolone

Answer 17

treat UTIs, protect from anthrax, and treats other bacterial infection
S: nausea, vomiting, diarrhea, dizziness, photosensitivity
O: GI, CNS, integumentary, skeletal
C: prototype is ciprofloxacin, monitor for CNS symptoms, decrease caffeine intake

Question 18

What effects does fluoroquinolones have on blood sugar levels?

Answer 18

fluoroquinolones can increase the effect of oral hypoglycemic med so monitor glucose levels

Question 19

When taking sulfonamides, what should be done?

Answer 19

several quarts of water should be drunk daily to prevent crystalluria

Question 20

Sulfonamides

Answer 20

treat UTIs, chronic bronchitis
S: nausea, vomiting, blood disorders, renal damage, skin reactions
O: GI, cardiac, kidney, integumentary
C: proto is a combo of trimethoprim and sulfamethoxazole, monitor GI symptoms, advise to drink 1200-1500 ml of water, monitor for low counts of CBCs and platelets
K:

Question 21

If you touch somebody with tuberculosis, what do you have to do?

Answer 21

prophylactic treatment with antitubercular therapy

Question 22

For pts taking antitubercular drugs, what can be done to prevent resistance to the antitubercular drugs?

Answer 22

multi drug therapy

Question 23

What is an adverse reaction to INH and what can be given to prevent this?

Answer 23

peripheral neuropathy, pyridoxine

Question 24

A patient is taking rifampin and notices their urine is a red-orange color. What is your next step?

Answer 24

ensure them that rifampin causes harmless discoloration of body liquids, also advise them to not wear contact lenses to avoid staining

Question 25

When should influenza neuraminidase inhibitors, such as zanamivir or oseltamivir, be taken?

Answer 25

within 48 hours of onset of symptoms for best effect

Question 26

What is phenazopyridine used for?

Answer 26

it treats symptomatic pain relief for cystitis

Question 27

What needs to be reported when taking Ditropan?

Answer 27

urinary retention but dry mouth, fatigue, and tachycardia

Question 28

What needs to be assessed when taking methchlorethamine?

Answer 28

tissue necrosis if there is pain at the IV site, the nurse stops the infusion

Question 29

What effects does diphenhydramine have on children?

Answer 29

excitation

Question 30

When should antacids be given?

Answer 30

1-3 hours after eating and at bedtime bc maximum acid secretion occurs

Question 31

When treating H. pylori peptic ulcer disease, how many antibiotics should be given?

Answer 31

two antibiotics bc h. pylori develops resistance rapidly

Question 32

How do proton pump inhibitors affect digoxin?

Answer 32

they enhance the effects of digoxin

Question 33

When taking levothyroxine, what needs to be increased?

Answer 33

insulin and oral antidiabetics should be increased bc levothyroxine decreased the effects of these drugs -monitor for hyperglycemia

Question 34

What should pts with hyperthyroidism be advised about?

Answer 34

iodine and how it is present in salt and shellfish

Question 35

What is propylthiouracil and what is it used for?

Answer 35

potent antithyroid drug that is used to prep for a subtotal thyroiddectomy

Question 36

When is calcitriol given?

Answer 36

to manage hypocalcemia caused by parathyroid hormone defiency

Question 37

What is lipo hypertrophy and what can cause it?

Answer 37

a raised lump on the skin caused by repeated injections into the same site -this can interfere with insulin absorption

Question 38

Where should insulin be stored?

Answer 38

if it's open, it can be stored at room temp for a month or refrigerated for 3 months

Question 39

Should ketoconazole be given with food?

Answer 39

yes

Question 40

What is topical miconazole used for?

Answer 40

vaginal candidiasis

Question 41

What is promethazine contraindicated for?

Answer 41

glaucoma, bc its anticholinergic

Question 42

What is a side effect of chloroquine?

Answer 42

visual injury bc of blurred vision and visual changes should be reported

Question 43

For patients taking drugs for ulcers, what should they be educated on?

Answer 43

the ulcer pain may subside in days but healing takes 1-2 months

Question 44

The transdermal scopolamine patch lasts 72 hours. When should it be taken off?

Answer 44

every 3 days

Question 45

What can glucocorticoids cause?

Answer 45

hyperglycemia

Question 46

When administering tolterodine tartrate, what effect does it have on bowel sounds?

Answer 46

it decreases bowel sounds and causes paralytic ileus