Pharmacology

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Author:
amgomez
ID:
107180
Filename:
Pharmacology
Updated:
2011-10-07 23:54:28
Tags:
Infection System Drugs
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Description:
Nursing Interventions
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  1. What interventions should the health care professional use when caring for a patient who is taking the antibacterial drug vancomycin (Vancocin)?
    • Administer over 1 hr by IV infusion because hypotension and flushing of the face and trunk (red-person syndrome) occur with rapid IV infusion. Follow recommendations for dilution.
    • Monitor vital signs during infusion.
    • Monitor vancomycin blood levels.
    • Determine baseline hearing acuity and monitor for hearing loss during treatment.
    • Monitor BUN and creatinine levels because the drug can cause nephrotoxicity.
    • Monitor IV infusion for redness and swelling.
    • Ensure that the IV is patent during infusion.
  2. What interventions should the health care professional use when caring for a patient who is taking the cephalosporin drug cephalexin (Keflex)?
    • Report bloody stools or watery diarrhea because the drug can cause pseudomembranous colitis.
    • Report cephalosporin or penicillin allergy before giving drug.
    • Prepare to treat rash/hives with antihistamines, and anaphylaxis with epinephrine and antihistamines.
    • Monitor for thrombophlebitis during IV infusion; for occurrence, stop infusion and change IV site.
    • Follow recommendations when diluting IV cephalosporins; infuse slowly.
  3. What interventions should the health care professional use when caring for a patient who is taking the penicillin drugs amoxicillin (Amoxil) and amoxicillin and clavulanic acid (Augmentin)?
    • Monitor for gastrointestinal symptoms.
    • Report bloody stools or long-term watery diarrhea because the drug can cause pseudomembranous colitis.
    • Report candida infections of mouth or vagina.
    • Treat candida infections with an antifungal agent.
    • Ask about penicillin allergy before first dose.
    • Monitor for allergy manifestations, and notify provider.
    • For injectable penicillins (IM or IV), keep patient for 30 min after administration, and monitor for allergy.
    • Prepare to treat rash or hives with antihistamines, and anaphylaxis with epinephrine and antihistamines.
  4. What interventions should the health care professional use when caring for a patient who is taking the antimycobacterial drug isoniazid (INH)?
    • Report gastrointestinal symptoms.
    • Encourage adherence to the drug regimen.
    • Monitor levels of liver enzymes throughout therapy because the drug can cause liver damage, including hepatitis, liver failure.
    • Report signs of liver damage.
    • Administer pyridoxine (vitamin B6) as prescribed for neuropathy (numbness, tingling, pain in the hands or feet).
    • Report CNS symptoms (dizziness, ataxia, seizures, psychotic symptoms).
  5. What interventions should the health care professional use when caring for a patient who is taking the antibacterial drug tetracycline (Sumycin)?
    • Give with nondairy foods if nausea, vomiting, diarrhea, or abdominal pain occur.
    • Report gastrointestinal symptoms (decreased dose may be required).
    • Determine whether patient could be pregnant before giving to women of childbearing age because the drug permanently discolors deciduous teeth of fetus (after fourth month of gestation).
    • Monitor liver function tests.
    • Monitor for symptoms of liver damage.
    • Monitor for signs of suprainfection.
    • Monitor for skin reactions because the drug can cause photosensitivity
  6. What interventions should the health care professional use when caring for a patient who is taking the antimycobacterial drug rifampin (Rifadin)?
    • Monitor liver enzyme levels throughout therapy because the drug can cause liver toxicity.
    • Report symptoms of hepatitis.
    • Monitor for red-orange discoloration of body fluids (urine, saliva, tears, sweat), a harmless effect.
    • Observe for presence of soft contact lenses.
    • Report persistent gastrointestinal symptoms.
  7. What interventions should the health care professional use when caring for a patient who is taking the sulfonamide drug trimethoprim and sulfamethoxazole (Bactrim, Septra)?
    • Report severe gastrointestinal symptoms.
    • Monitor for rash and hives.
    • Report symptoms of blood cell deficiencies (thrombocytopenia, leukopenia, anemia).
    • Report severe diarrhea or candida infection.
    • Report rash and/or blisters because the drug can cause Stevens-Johnson syndrome.
  8. What interventions should the health care professional use when caring for a patient who is taking the antiparasitic drug metronidazole (Flagyl)?
    • Report severe gastrointestinal symptoms.
    • Report CNS symptoms; discontinue for seizure or neuropathy.
    • Advise patient to expect dark urine (a harmless effect).
    • Report candida infection in vagina or in mouth/throat.
  9. What interventions should the health care professional use when caring for a patient who is taking the antiviral drug acyclovir (Zovirax)?
    • Report severe skin reactions.
    • Report severe gastrointestinal symptoms, headache, or vertigo.
    • Monitor BUN, creatinine levels because the drug can cause renal toxicity.
    • Infuse IV form slowly; hydrate patient during and for 2 hr following infusion to maintain urine output.
    • Report restlessness, tremors, psychosis, seizures.
    • Carefully monitor IV during infusion because infiltration can cause tissue damage.
  10. What interventions should the health care professional use when caring for a patient who is taking the monobactam drug aztreonam (Azactam)?
    • Monitor site for redness, swelling, or pain.
    • Change IV sites if inflammation occurs.
    • Monitor for and report candida infections of mouth or vagina.
    • Expect to treat candida infections with an antifungal agent.
  11. What interventions should the health care professional use when caring for a patient who is taking the urinary tract antiseptic nitrofurantoin (Macrodantin)?
    • Report gastrointestinal symptoms (dose may be reduced or form of drug may be changed to minimize symptoms).
    • Report respiratory symptoms (drug will be discontinued).
    • Report symptoms of neuropathy.
    • Monitor laboratory values of blood components because the drug can cause blood cell dysfunction (anemia, including macrocytic anemia, thrombocytopenia, neutropenia).
    • To prevent staining, do not crush capsules; dilute suspension in milk or juice before administration; instruct patient to rinse mouth if taking suspension.
  12. What interventions should the health care professional use when caring for a patient who is taking the antiparasitic drug chloroquine (Aralen)?
    • Report any visual symptoms (blurred vision, photophobia).
    • Report severe gastrointestinal symptoms.
  13. What interventions should the health care professional use when caring for a patient who is taking the fluoroquinolone drug ciprofloxacin (Cipro)?
    • Report CNS symptoms (dizziness, headache; confusion in an older adult).
    • Report gastrointestinal symptoms (a decrease in dose may be needed).
    • Report tendon pain because the drug can cause Achilles tendon rupture (discontinue if pain occurs).
    • Advise patients to protect skin from sun exposure with clothing and sunscreen.
  14. What interventions should the health care professional use when caring for a patient who is taking the polyene antibiotic drug amphotericin B (Fungizone)?
    • Administer prescribed diphenhydramine (Benadryl) and acetaminophen (Tylenol) before beginning infusion to prevent infusion reactions.
    • Monitor vital signs and for symptoms during infusion.
    • Monitor BUN, creatinine, blood potassium every few days during treatment, and notify provider for abnormal value because the drug can cause renal toxicity.
    • Monitor weight, and intake and output; notify provider of low output and weight changes.
    • Monitor Hct, CBC, and notify provider for falling values because the drug can cause anemia.
  15. What interventions should the health care professional use when caring for a patient who is taking the aminoglycoside drug Gentamicin (Garamycin)?
    • Report tinnitus and other symptoms of early ototoxicity.
    • Monitor peak and trough blood levels.
    • Monitor laboratory values (BUN, creatinine, urine for protein, casts) and report elevations because the drug can cause nephrotoxicity (polyuria, dilute urine, protein and casts in urine, elevated BUN, creatinine).
  16. What interventions should the health care professional use when caring for a patient who is taking the azole drug ketoconazole (Nizoral)?
    • Report changes in liver function tests during treatment.
    • Report severe gastrointestinal symptoms.
    • Report CNS effects (dizziness, drowsiness).
    • Report hormonal symptoms (gynecomastia, decreased libido, low sperm counts, menstrual irregularities).
  17. What interventions should the health care professional use when caring for a patient who is taking the macrolide drug erythromycin (E-Mycin)?
    • Report gastrointestinal reactions (a decrease in the dose may stop symptoms).
    • Monitor for concurrent use of other drugs that increase erythromycin blood levels.
    • Question patient about history of prolonged QT because the drug can cause ventricular dysrhythmias.
    • Report signs of ototoxicity (hearing loss, vertigo and tinnitus).
    • Report suprainfection.
  18. What interventions should the health care professional use when caring for a patient who is taking the carbapenem drug imipenem (Primaxin)?
    • Follow recommended rate when infusing IV form.
    • Monitor for nausea during infusion; treat with antiemetic.
    • Monitor IV site for redness and swelling during infusion.
    • Assess for and report antibiotic allergy prior to infusing imipenem.
    • Monitor for secondary infections, such as oral candidiasis

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