Chapter 08 Anti-infective Agents

1. A patient asks the nurse how an anti-infective produces a therapeutic effect. What key point will the nurse explain to this patient?

1. A)  Drugs used to treat infections date back to the 17th century.
2. B)  All anti-infectives work in the same way to destroy organisms.
3. C)  Selective toxicity determines the appropriate drug dosage needed.
4. D)  The goal of anti-infectives is to interfere with normal functioning of the organism.

Ans: D

Feedback:

The goal of anti-infectives is to interfere with the normal function of the invading organism to prevent it from reproducing and to cause cell death without affecting host cells. Each class of anti-infectives works in a different way, but all have the same goal. Because bacteria cells have a slightly different composition than human cells, the bacteria are destroyed without interfering with the host. The first drugs used to treat systemic infections were developed in the early 20th century. The term selective toxicity refers to the ability to affect certain proteins or enzyme systems that are used by infecting organisms, but not by human cells.

2. The nursing student learns about anti-infectives in class and demonstrates the need to study more when making what statement about how anti-infectives work?

1. A)  Some anti-infectives interfere with biosynthesis of the pathogen’s cell wall.
2. B)  Some anti-infectives prevent the cells of the organism from using essential substances.
3. C)  Many anti-infectives interfere with the steps involved in protein synthesis.
4. D)  Some anti-infectives interfere with ribonucleic acid (RNA) synthesis in the cell leading to cell death.

Ans: D

Feedback:

Some anti-infectives interfere with deoxyribonucleic acid (DNA) synthesis, not RNA synthesis, in the cell, leading to inability to divide and causing cell death. The fluoroquinolones work in this way. The other three options are correct and would not indicate the need for further study time. Penicillins

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interfere with biosynthesis of the cell wall, sulfonamides prevent organisms from using substances essential to their growth and development, whereas aminoglycosides, macrolides, and chloramphenicol interfere with protein synthesis.

3. The nurse administers a drug to treat Neisseria gonorrhoeae that works on no other bacteria. How would the nurse describe this drug?

1. A)  Broad spectrum
2. B)  Narrow spectrum
3. C)  Bactericidal
4. D)  Bacteriostatic

Ans: B

Feedback:

Without knowing the name of the antibiotic and how it works to treat N. gonorrhoeae, the only thing that can be said is that it is a narrow-spectrum anti-infective because it only treats one specific organism. Broad-spectrum anti-infectives treat multiple organisms. The name of the drug and how it works would need to be known to determine whether it is bacteriocidal or bacteriostatic.

4. The nurse has provided patient teaching for a patient who will be discharged to home on an anti- infective. What statement made by the patient indicates the nurse needs to provide additional teaching concerning the use of anti-infectives?

1. A)  ​Antibiotics will not help me when I have a viral infection.​
2. B)  ​A bacterial culture will be done before antibiotics are prescribed for me.​
3. C)  ​I could develop diarrhea as a result of taking an antibiotic.​
4. D)  ​I will stop taking the antibiotic as soon as I feel better.​

Ans: D

Feedback:

Compliance with anti-infective therapy is a concern. Patients tend to stop taking the drugs when they begin to ​feel better.​ A nurse should instruct the patient to take the entire course of prescribed drug to ensure a sufficient period to rid the body of pathogens and to help prevent the development of resistance. Antibiotics are not prescribed for viral infections. It is important that cultures be performed before antibiotics are prescribed to determine what organism is causing the infection so that the correct drug is prescribed. Diarrhea is the most common adverse effect from anti-infectives.

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5. The nurse attends a class on preventing resistance to anti-infectives and learns that the critical concept in preventing the development of resistant strains of microbes is what?

1. A)  Exposure of pathogens to an antimicrobial agent without cellular death
2. B)  Drug dosages that are below a therapeutic level
3. C)  The duration of drug use
4. D)  Frequency of drug ingestion

Ans: C

Feedback:

Exposure of pathogens to an antimicrobial agent without cellular death leads to the development of resistance so it is important to limit the use of these agents to treat pathogens with a known sensitivity to the drug being used. Drug dosages are also important in preventing the development of resistance. However, the duration of drug use is critical to ensure that microbes are completely eliminated and not given the chance to grow and develop resistant strains. It is hard to convince patients that they must always complete the entire course of antimicrobial agents when they begin to ​feel better,​ because stopping early favors the emergence of drug-resistant strains.