Chapter 09 Antibiotics

1. A 32-year-old female patient is admitted to the floor with a superinfection. Her orders read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over 30 to 60 minutes for 5 days. What would be important for the nurse to educate this patient about?

1. A)  Analgesics
2. B)  Antihistamines
3. C)  Contraceptives
4. D)  Decongestants

Ans: C

Feedback:

Many antibiotics interfere with the effectiveness of oral contraceptives and unplanned pregnancies can occur. Women should be advised to use a barrier form of contraceptives when taking this drug. No known serious drug​drug interactions involve analgesics, antihistamines, or decongestants.

2. A patient with a gram-negative infection is being treated with an aminoglycoside. What system should the nurse expect to monitor closely while the patient is taking this medication?

1. A)  Respiratory system
2. B)  Ophthalmic system
3. C)  Renal system
4. D)  Musculoskeletal system

Ans: C

Feedback:

Renal function should be tested daily because aminoglycosides depend on the kidney for excretion and if the glomerular filtration rate (GFR) is abnormal it may be toxic to the kidney. The results of the renal function testing could change the daily dosage. Aminoglycosides do not usually adversely affect respiratory, hepatic, or musculoskeletal function, although baseline data concerning these systems is always needed.

3. How would the nurse describe selective toxicity?

Test Bank – Focus on Nursing Pharmacology (7th Edition by Amy Karch) 139

1. A)  Selective toxicity interferes with a biochemical reaction common to many different organisms.
2. B)  Selective toxicity will decrease invading bacteria by interfering with the pathogens’ ability to reproduce.
3. C)  Selective toxicity will eliminate bacteria by interrupting protein synthesis and damaging the pathogen’s cell wall.
4. D)  Selective toxicity is the ability of the drug to kill foreign cells without causing harm to one’s own body cells.

Ans: D

Feedback:

The choice of antibiotics in a clinical situation is determined by assessing which drug will affect the causative organism and lead to the fewest adverse effects. Selective toxicity is the ability of the drug to kill foreign cells without causing harm to the human body cells. How the antibiotic works to kill bacteria varies by drug type and may reduce the ability to reproduce, damage the cell wall, or interfere with a biochemical reaction, but this is a description of how the antibiotic works and does not describe selective toxicity

4. A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose?

1. A)  Ciprofloxacin (Cipro)
2. B)  Gemifloxacin (Factive)
3. C)  Norfloxacin (Noroxin)
4. D)  Sparfloxacin (Zagam)

Ans: A

Feedback:

Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute episodes of chronic bronchitis and community-acquired pneumonia. Norfloxacin is recommended only for certain types of urinary tract infections.

5. A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician has ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an oral suspension of 90 mg/5 mL. How many mL will the nurse administer?

Test Bank – Focus on Nursing Pharmacology (7th Edition by Amy Karch) 140

1. A)  5 mL
2. B)  10 mL
3. C)  15 mL
4. D)  20 mL

Ans: C

Feedback:

First, using the formula: 2.2 lb/1 kg = 66 lb/X kg, determine the child’s weight in kg (66/2.2 = 30 kg). Next, determine the desired dose by using the formula: amount of prescribed drug times weight in kg (9 mg/kg times 30 kg = 270 mg). To determine the volume of medication to administer, use the formula: amount of drug available/volume available = amount of drug prescribed/volume to administer (90 mg/5 mL = 270 mg/X mL, 90mg/(X) = 1,350 mg/mL, X = 15 mL).