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NUR3145 Exam #2 Study Guide
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NUR3145 Exam #2 Study GuideHow is antibiotic selection determined? - Answer Identification of the causative
organism
Based on the culture report, an antibiotic is chosen that has been known to be effective
at treating the invading organism
Adverse effects of long-term antibiotic use - Answer Greater the chance that the
bacteria will develop into a resistant strain
Decreased effectiveness of oral contraceptives
Common patient teaching for antibiotic use - Answer Take the whole thing
Penicillins - Answer Penicillin, amoxicillin, ampicillin
Indications of Penicillin - Answer Severe infections caused by sensitive organisms and
broad spectrum use
Action of Penicillin - Answer Interfere with the ability of susceptible bacteria to build
their cell walls
Contraindications/Cautions of Penicillin - Answer Allergies to penicillin or
cephalosporins, renal disease
Use cautiously in patients who are pregnant or lactating
Adverse effects of Penicillin - Answer Most significant GI tract, anaphylaxis, rash/hives
Nursing Considerations of Penicillin - Answer - culture and sensitivity before treatment
- monitor serum electrolytes and cardiac status if given IV
- monitor and rotate injection sites, monitor for 20 min after IM
- good mouth care
- 1-2 hr ac or 2-3 hr pc => reduce gastric acid destruction
- yogurt or buttermilk if diarrhea develops => loose, foul-smelling stool
- instruct patient to take missed drugs as soon as possible, do not double dose
- check cross-sensitivity with cephalosporins
Cephalosporins - Answer cephalexin, ceftriaxone
Indications of Cephalosporins - Answer treatment of infections caused by susceptible
bacteria
, Action of Cephalosporins - Answer Interfere with the cell wall-building ability of bacteria
when they divide
Contraindications/Cautions of Cephalosporins - Answer Allergies to cephalosporins or
penicillin, liver or renal impairment
Adverse effects of Cephalosporins - Answer Mild diarrhea, abdominal cramps, rash,
pruritus, redness, edema
Nursing Considerations of Cephalosporins - Answer - take with food
- avoid alcohol
- cross allergy with PCN (don't take if allergic to PCN)
Carbapenems - Answer Meropenem
Indications of Carbapenems - Answer Treatment of serious infections caused by
susceptible bacteria
Action of Carbapenems - Answer Inhibit cell membrane synthesis in susceptible
bacteria, leading to cell death
Contraindications/Cautions of Carbapenems - Answer Known allergy to any of the
carbapenems or betalactams, seizure disorders, meningitis, pregnancy and lactation
Adverse effects of Carbapenems - Answer Pseudomembranous colitis, C. diff diarrhea,
and nausea and vomiting can lead to serious dehydration and electrolyte imbalances, as
well as to new serious infections/superinfections
Nursing Considerations of Carbapenems - Answer Observe intravenous site closely for
extravasation. Observe for signs of renal, hepatic, or hematological dysfunction.
Observe for skin rashes. Measure urine output.
Indications of Vancomycin - Answer Treatment of serious infections caused by bacteria,
especially MRSA
Action of Vancomycin - Answer Binds to bacterial cell wall, resulting in cell death
Contraindications/Cautions of Vancomycin - Answer May affect the kidneys (BUN)
Adverse effects of Vancomycin - Answer nephrotoxicity, ototoxicity, red man syndrome
Nursing Considerations of Vancomycin - Answer - Monitor blood levels to ensure
therapeutic levels and prevent toxicity
- Ensure adequate hydration (2L of fluids/24hrs) to prevent nephrotoxicity
- Infuse over 60 minutes
- Monitor drug levels
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