Nursing Drug Reference Weeks 10 and 11

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sisterbarley
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179336
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Nursing Drug Reference Weeks 10 and 11
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2012-11-01 02:24:45
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Medications
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Medication Flashcards for weeks 10 and 11
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  1. Name some common nonnarcotic analgesics
    • Aspirin
    • Acetaminophen
    • Ibuprofen
    • Naproxen (Alieve)
  2. What do the analgesics do?
    • Controls pain
    •  - Headaches
    •  - Inflammation
    •  - Abrasions
    •  - Muscle aches
    •  - Arthritis pain
  3. Name some common Nonsteroidal anti-inflammatory drugs (NSAIDS)
    • Aspirin
    • Ibuprofen
    • Naproxen
  4. What can aspirin do for you?
    • Analgesic: Inhibits pain
    • Antipyretic: Works on fevers
    • Anti-inflammatory: Decreases inflammation
    • Preventative measures against: TIA's, MI's or other thromboembolotic episodes
  5. Who should not take Aspirin?
    Children <12
  6. How does Aspirin work?
    • Inhibits the platelet aggregation (inhibits their ability to stick together)
    • NOTE: Think of it like "slick 50" for your car - it makes them so slippery, they can't stick together
  7. Which enzymes does Aspirin work on?
    Inhibits cyclooxygenase (Cox 1 and Cox 2)
  8. What is a common side effect of Aspirin?
    Gastric irritation, bleeding, and ulcers
  9. What does the enzyme Cox 1 do?
    • Protects the stomach lining: thus, when Aspirin inhibits this enzyme you get the gastric bleeding
    • Promotes platelet aggregation: Helps clump platelets together, thus, Aspirin inhibits this and you get the "slick 50" effect
  10. What enzymes does Ibuprofen inhibit?
    Cyclooxygenase (Cox 1 and Cox 2)
  11. What are the two NSAIDS that work on Cyclooxygenase (Cox 1 and Cox 2)?
    • Aspirin
    • Ibuprofen
  12. Because Ibuprofen inhibits Cyclooxygenase (Cox 1 and Cox 2) what is a side effect of using this NSAID?
    Gastric bleeding and ulcers can occur
  13. Why would you use Naproxen?
    • Inflammation and inflammatatory diseases: Gout
    • Pain: osteo and rheumatoid arthritis
  14. What is a good analgesic to use for arthritis?
    Celebrex
  15. What would you not use Celebrex for?
    • Strokes
    • MI's
  16. What does Celebrex do for the patient with arthritis?
    Decreases pain and inflammation
  17. What enzyme does Celebrex work on?
    Blocks Cox 2 enzyme
  18. Since Celebrex only blocks the enzyme Cox 2,  you will not have the side effects of  ____A____ or ____B_____, which are commonly seen in Apirin and Ibuprofen use.
    • A. Gastric bleeding
    • B. Ulcers
  19. True or False
    You need a perscription for Celebrex?
    True
  20. True or False
    Acetaminophen is an NSAID
    False
  21. True or False
    Acetaminophen is a non-narcotic?
    True
  22. True or False
    Acetaminophen is an anti-inflammatory
    False
  23. What problems does Acetaminophen treat?
    • Relieves pain
    • Helps with discomfort
    • Brings down a fever
  24. How often is Acetaminophen purchased?
    25% of all over the counter (OTC) drugs sold
  25. How does Acetaminophen affect your GI?
    Little to no gastric distress
  26. True or False
    Acetaminophen inhibits platelet aggregation
    False
  27. Can you overdose on Acetaminophen?
    Yes, too much is toxic to the liver cells
  28. Since Acetaminophen can be toxic to the liver cells, who should not take it?
    • Individuals with Renal or Liver disease
    • Alcoholics
  29. Which labs will a nurse consider, with an order for Acetaminophen?
    Liver labs: ALT, AST, and billirubin
  30. How are narcotic analgesics stored in the healthcare setting?
    • Computerized/locked medication systems
    • "Pyxis" or med-cart system
    • Locked
    • Secured area
    • Fingerprint and password access
  31. Define a controlled substance
    A drug whose manufacture, possession, and use are regulated by the government
  32. What are a few of the procedures, when administering controlled substances, in the heathcare facility?
    • Strict documentation
    • Counted and monitored each shift
    • Wasting must be witnessed by another licensed personnel
  33. What is the purpose of the controlled substance act?
    To indicate drugs with the potential for abuse
  34. How many schedules are there for measuring a controlled substance?
    Schedule I - V
  35. Define Controlled Substance Abuse Schedule I
    Give an example of what drug may be included in this schedule
    • No accepted medical use: High potential fo abuse
    • Only exception is peyote use by Native Americans
    • Example: Heroine
  36. Define Controlled Substance Abuse Schedule II
    Give an example of what drug may be included in this schedule
    • Some medical uses: high potential for abuse
    • Example: Oxycodone
  37. Define Controlled Substance Abuse Schedule III
    Give an example of what drug may be included in this schedule
    • Medically accepted: may cause dependence
    • Example: Tylenol III
  38. Define Controlled Substance Abuse Schedule IV
    Give an example of what drug may be included in this schedule
    • Medically accepted: may cause dependence
    • Example: Ativan, Ambien, etc.
  39. Define Controlled Substance Abuse Schedule V
    Give an example of what drug may be included in this schedule
    • Medically accepted: Very limited potential for dependence
    • Example: Codeine cough syrup
  40. What are a few of the opiod analgesics?
    • Codeine
    • Demeraol (meperedine)
    • Percocet/Percodan
    • Fentanyl
  41. Define analgesic
    Any member of the group of drugs used to relieve pain
  42. What is an opiod antagonist?
    • It is a drug that acts as an antidote to an opiod overdose
    • Used to counteract opiod-induced respiratory depression
  43. What is a common opiod antagonist drug?
    naloxone (Rx) Narcan
  44. What would you ensure you have with you, prior to administering naloxone (Rx) Narcan?
    Administer only with resuscitative equipent and O2 nearby
  45. What nursing assessment would you take after administering Narcan?
    • Vital Signs (VS): Every 3-5 minutes
    • Respirations: Character, rate, rhythm
  46. What does a Skeletal Muscle Relaxant (Soma) do?
    Inhibits synaptic responses in the CNS: decreased neurotransmission,  decreased pain, and decreased spasticity or spasms
  47. What are some common side effects of the skeletal muscle relaxant (Soma)?
    • Dizziness
    • weakness
    • Fatigue
    • Drowsiness
    • Headache
  48. What are the nurse teaching points that need to be made for a client on skeletal muscle relaxants (Soma)?
    • Do not drink alcohol or take other CNS depressants
    • Avoid hazardous activities while taking Somas
    • Do not discontinue use quickly, must be tapered off
  49. What is one of the trade names for morphine (Rx)?
    Sulfate
  50. What is the generic name for Sulfate?
    morphine (Rx)
  51. For morphine (Rx), Sulfate, what is the functional class?
    Opiod analgesic
  52. For morphine (Rx), Sulfate, what is the alert status?
    High Alert!
  53. For morphine (Rx), Sulfate, what is the chemical class?
    Alkaloid
  54. For morphine (Rx), Sulfate, what is the action?
    Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors
  55. For morphine (Rx), Sulfate, what are the uses?
    Moderate to severe pain
  56. For morphine (Rx), Sulfate, what are the contraindications?
    • Hypersensitivity, addition (opioid), hemorrhage, bronchial asthma, increased intracranial pressure, paralytic ileus, hypovolemia, shock
    • BLACK BOX WARNING: Respiratory depression - Do not give with other CNS depressive medications
  57. For morphine (Rx), Sulfate, what are the contraindication precautians?
    • Pregnancy (C), breast feeding, children <18 yr, geriatric patients, addictive personality, acute MI, sever heart disease, renal/hepatic disease, bowel impaction
    • BLACK BOX WARNING: Abrupt discontinuation, accidental exposure, epidural/introthecal administrtion, opioid-naive patients, substance abuse
  58. For morphine (Rx), Sulfate, what are the side effects on the CNS?
    • Common: NONE
    • Life threatening: Seizures
  59. For morphine (Rx), Sulfate, what are the side effects on the CV?
    • Common: NONE
    • Life threatening: Bradycardia, shock, cardiac arrest, and tachycardia
  60. For morphine (Rx), Sulfate, what are the side effects on the HEMA?
    • Common: NONE
    • Life threatening: Thrombocytopenia
  61. For morphine (Rx), Sulfate, what are the side effects on the RESP?
    • Common: NONE
    • Life threatening: Respiratory depression, respiratory arrest, apnea
  62. For morphine (Rx), Sulfate, what are the pharmocokinetics?
    • PO: Onset variable, peak variable, duration variable
    • IM: Onset 1/2 hr, peak 50-90 min, duration 3-7hr
    • SubQ: Onset 15-20 min, peak 50-90 min, duration 3-5hr
    • IV: Peak 20 min
    • RECT: Peak 1/2-1 hr, duration 4-5 hr
    • Intrathecal: Onset rapid, duration equal to or <24 hr
    • Metabolized: By liver
    • Crosses: Placenta
    • Excreted: in urine, breast milk;
    • Half-life: 1 1/2 - 2 hr
  63. For morphine (Rx), Sulfate, what is involved with the NURSING ASSESSMENT?
    • Pain: location, type, character; give dose before pain becomes severe
    • Bowel status: constipation common, use stimulant laxative if needed
    • I&O ratio: check for decreasing output, may indicate urinary retention
    • B/P: pulse, respirations (character, depth, rate)
    • CNS changes: dizziness, drowsiness, hallucinations, euphoria, LOC, pupil reaction
    • Alercgic reactions: rash, urticaria
    • Respiratory dysfunction: depression, character, rate, rhythm; notfy prescriber if respirations are <12/min; accidental overdose has occurred with high-potency orals sols
    • BLACK BOX WARNINGS
    • Abrupt discontinuation: gradually taper to prevent withdrawal symptoms; decrease by 50% q 1-2 days; avoid use of narcotic antagonists
    • Accidental exposure: if Duramorph or Infumorph gets on skin, remove contaminated clothing, rinse affected area with water
  64. For morphine (Rx), Sulfate, what is involved with the NURSING PERFORM/PROVIDE?
    • Storage: In light-resistanct container at room temp
    • Assistance: With ambulation
    • Safety measures: side rails, night-light, call bell within easy reach
    • Gradual withdrawal: After long-term use
  65. For morphine (Rx), Sulfate, what is involved with the NURSING EVALUATION?
    • Therapeutic response
    • Decrease in pain intensity
  66. For morphine (Rx), Sulfate, what is involved with the NURSE TEACHING PATIENT/FAMILY?
    • To change position slowly; orthostatic hypotension may occur
    • To report any symptoms of CNS changes, allergic reactions
    • Physical dependency may result from long term use
    • Avoid use of alcohol, CNS depressants
    • Withdrawal symptoms may occur: nausea, vomiting, cramps, fecer, faintness, and anorexia
  67. How do you treat an overdose of morphine?
    • Naloxone (Narcan) 0.2-0.8 mg IV
    • O2
    • IV fluids
    • Vasopressors
  68. What are the following drugs used for?
    1. enoxaparin (Rx), Lovenox
    2. Heparin
    3. warfarin (Rx), Coumadin
    • 1. It is used to PREVENT a clot
    • 2. It is used when a client HAS a clot
    • 3. It is used when a client has HAD a clot
  69. How does enoxaparin (Rx), Lovenox, prevent a clot?
    • Inactivation of Factors X: Prevents the conversion of prothrombin to thrombin
    • Limits: Fibrin formation of stable clot
    • Prolonged: Clotting time
    • No effects: On blood clots already formed
    • NOTE: It increases the clotting time
  70. By preventing a blood clot, what other illnesses do you prevent?
    • Myocardial Infarction (MI) - A clot in the heart
    • Stroke - A clot in the brain
  71. How does warfarin sodium (Rx), Coumadin work on a client's system, when they have had a clot?
    • Competitive blocking of vitamin K: Prevents synthesis of Vitamin K in th liver
    • Subsequent prevention of the actication of dependent clotting factors, including: Factor II (prothombin), Factor VII, Factor IX, and Factor X
  72. Which test do you run on Heparin:
    PT or PTT?
    • PTT, which is a test to find out if the right dose of heparin is being used.
    • Clue: The two TT's can form an H!

    NOTE: Partial thromboplastin time (PTT) and prothrombin time (PT/INR) are often done at the same time to check for bleeding problems or the chance for too much bleeding in surgery.
  73. Define PT, INR, or PT/INR
    • Prothrombin time (PT) is a blood test that measures how long it takes blood to clot. A prothrombin time test can be used to check for bleeding problems. PT is also used to check whether medicine to prevent blood clots is working.
    • A PT test may also be called an INR test. INR (international normalized ratio) stands for a way of standardizing the results of prothrombin time tests, no matter the testing method. So your doctor can understand results in the same way even when they come from different labs and different test methods. Using the INR system, treatment with blood-thinning medicine (anticoagulant therapy) will be the same. In some labs, only the INR is reported and the PT is not reported.Blood clotting factors are needed for blood to clot (coagulation). Prothrombin, or factor II, is one of the clotting factors made by the liver. Vitamin K is needed to make prothrombin and other clotting factors. Prothrombin time is an important test because it checks to see if five different blood clotting factors (factors I, II, V, VII, and X) are present.

    • The prothrombin time is made longer by:
    • 1. Blood-thinning medicine, such as heparin. [Another test, the activated partial thromboplastin time (APTT) test, is a better test to find out if the right dose of heparin is being used.]
    • 2. Low levels of blood clotting factors.
    • 3. A change in the activity of any of the clotting factors.
    • 4. The absence of any of the clotting factors.
    • 5. Other substances, called inhibitors, that affect the clotting factors.
    • 6. An increase in the use of the clotting factors.
    • NOTE: An abnormal prothrombin time is often caused by liver disease or injury or by treatment with blood thinners.
  74. For enoxaparin (Rx), Lovenox, what is the functional class?
    Anticoagulant, antithrombotic
  75. For enoxaparin (Rx), Lovenox, what is the chemical class?
    Low-molecular-weight heparin (LMWH)
  76. For enoxaparin (Rx), Lovenox, what is the action?
    Binds to antithrombin III inactivting factors Xa/IIa, thereby resulting in a higher ratio of anti-factor Xa to IIa
  77. For enoxaparin (Rx), Lovenox, what are the uses?
    Prevention of deep vein thrombosis (DVT), [inpatient or outpatient], PE (pulmonary embolism), [inpatient] in hip and knee replacement, abdominal surgery at risk for thrombosis; unstable angina/non-Q-wave MI
  78. For enoxaparin (Rx), Lovenox, what are the contraindications?
    • Hypersensitivity to this product, benzyl alcohol, heparin, pork*; active major bleeding, hemophilia, leukemia with bleeding, peptic ulcer disease, thrombocytopenic purpur, heparin-induced thrombocytopenia
    • * indicates an unusual finding
  79. For enoxaparin (Rx), Lovenox, what are the contraindication precautions?
    • Pregnancy (B)
    • Breastfeeding
    • Children
    • Geriatric patients 
    • Low weight men (<57 kg), women (<45 kg)
    • Severe renal/hepatic disease
    • Blood dyscrasias
    • Severe hypertension
    • Subacute bacterial endocarditis
    • Acute nephritis
    • Recent burn
    • Spinal surgery
    • Indwelling catheters
    • BLACK BOX WARNING: Lumbar puncture, epidural anesthesia, and spinal anesthesia
  80. For enoxaparin (Rx), Lovenox, when is it safe to administer the medication?
    • Only after screening patient for bleeding disorders (PT)
    • Do no mix with other products or inf fluids
    • **ONLY this product when ordered; not interchangeable wth heparin or other LMWHs
    • At same time each day to maintain steady blood levels
    • Avoid all IM inj that may cause bleeding
    • Prepare in a sterile environment using aseptic technique
    • Dilution may be stored for up to 4 wk in glass vial at room temp, up to 2 wk in TB syringes with rubber stoppers at room temp or refrigerated
  81. For enoxaparin (Rx), Lovenox, how should the medication be administered?
    • "Love Qt Bubbles, but hate to aspirate!"
    • SubQ route: DO NOT give IM (begin 1 hour prior to surgery)
    • DO NOT aspirate
    • Rotate sites
    • DO NOT expel the bubble from the syringe before administration
    • NOTE: Inject slowly (slow taps) for about 20-30 seconds, wait 10 seconds before pulling out the needle, this will keep the client from getting a bruise
  82. For enoxaparin (Rx), Lovenox, what are the side effects on the HEMA?
    • Common: NONE
    • Life threatening: Hemorrhage, hypochromic anemia, thrombocytopenia, and bleeding
  83. For enoxaparin (Rx), Lovenox, what are the pharmacokinetics?
    • SubQ: 90% absorbed
    • Maximum antithrombin activity: 3-5 hour
    • Elimination half-life: 4 1/2 hr
    • Excreted: In urine
  84. For enoxaparin (Rx), Lovenox, what is involved with the NURSING ASSESSMENT?
    • Blood studies: (Hct/Hgb, CBC, coagulation studies, platelets, occult blood in stools), anti-factor Xa (should be checked 4 hr after inj); thrombocytopenia may occur
    • Renal studies: BUN/creatinine baseline and periodically
    • Bleeding: Gums, petechiae, ecchymosis, black tarry stools, hematuria - Notify Prescriber
    • BLACK BOX WARNING: Neurologic symptoms in patients who have received spinal anesthesia
  85. For enoxaparin (Rx), Lovenox, what is involved with the NURSING PERFORM/PROVIDE?
    • Storage at 77 degrees F (25 degrees C)
    • Do not freeze
  86. For enoxaparin (Rx), Lovenox, what is involved with the NURSING EVALUATION?
    Therapeutic response: Prevention of DVT
  87. For enoxaparin (Rx), Lovenox, what is involved with the NURSE TEACHING PATIENT/FAMILY?
    • To use soft-bristle toothbrush: To avoid bleeding gums
    • To use electric razor: To avoid bleeding from nicks/cuts
    • To report any signs of bleeding: gums, under skin, urine, and stools
    • To avoid OTC products containing aspirin (anticoagulant) unless approved by prescriber
  88. For enoxaparin (Rx), Lovenox, how do you treat an overdose?
    • Protamine SO4 1% sol
    • Dose should equal dose of enoxaparin
  89. For warfarin (Rx), Coumadin, what is the functional class?
    Anticoagulant
  90. For warfarin (Rx), Coumadin, what is the chemical class?
    Coumarin derivative
  91. For warfarin (Rx), Coumadin, what is the action?
    Interferes with blood clotting by indirect means; depresses hepatic synthesis of vit K-dependent coagulation factors (II, VII, IX, X)
  92. For warfarin (Rx), Coumadin, what are the uses?
    Antiphospholipid antibody syndrome, arterial thromboembolism prophylaxis, DVT, MI prophylaxis, after MI, stroke prophylaxis, and thrombosis prophylaxis
  93. For warfarin (Rx), Coumadin, what are the unlabeled uses?
    Angina and unstable angina
  94. For warfarin (Rx), Coumadin, what are the contraindications?
    Pregnancy (X), breastfeeding, hypersensitivity, hemophilia, leukemia with bleeding, peptic ulcer disease, thrombocytopenic purpura, hepatic disease (severe), malignant hypertension, subacute bacterial endocarditis, acute nephritis, blood dyscrasias, eclampsia, preeclampsia, hemorrhagic tendencies; surgery of CNS, eye; traumatic surgery with large open surface, bleeding tendencies of GI/GU/Respiratory tract, stroke, aneurysms, pericardial effusion, spinal puncture, major regional/lumbar block anesthesia
  95. For warfarin (Rx), Coumadin, what are the contraindication precautions?
    Geriatric patients, alcoholism, CHF, debilitated patients, trauma, indwelling catheters, severe hypertension, active infections, protein C deficiency, polycythemia vera, vasculitis, severe diabetes, Asian patients (CYP2C9, VKORC1)
  96. For warfarin (Rx), Coumadin, what are the side effects on the CNS?
    • Common: Fever
    • Life threatening: NONE
  97. For warfarin (Rx), Coumadin, what are the side effects on the GI?
    • Common: Diarrhea
    • Life threatening: Hepatitis
  98. For warfarin (Rx), Coumadin, what are the side effects on the GU?
    • Common: NONE
    • Life threatening: Hematuria
  99. For warfarin (Rx), Coumadin, what are the side effects on the HEMA?
    • Common: NONE
    • Life threatening: Hemorrhage, agranulocytosis, leukopenia, and eosinophilia
  100. For warfarin (Rx), Coumadin, what are the side effects on the INTEG?
    • Common: Rash
    • Life threatening: NONE
  101. For warfarin (Rx), Coumadin, what are the side effects on the SYST?
    • Common: NONE
    • Life threatening: Anaphylaxis, exfoliative dermatitis, and purple toe syndrome (blood pools here, can also happen in the fingers)
  102. For warfarin (Rx), Coumadin, what are the pharmacokinetics?
    • Onset: 12-24 hours
    • Peak: 1 1/2-4 days
    • Duration: 3-5 days
    • Effective half-life: 20-60 hours
    • Metabolized: In the liver
    • Excreted: In the urine, feces (active/inactive metabolites)
    • Crosses: placenta
    • Bound to plasma proteins: 99% (must have albumin test!)
  103. For warfarin (Rx), Coumadin, what are the side effects on the pharmacotherapeutics?
    • 1. Thrombus: Completion of therapy following heparin
    • 2. Pulmonary embolism: Completion of therapy following heparin
    • 3. Long-term prophylaxis: For thrombus prevention
    • 4. Prophylaxis: For atrial fibrillation
  104. For warfarin (Rx), Coumadin, what is involved with the NURSING ASSESSMENT?
    • BLACK BOX WARNING:
    • Blood studies: (Hct, PT, platelets, occult blood in stools) q3mo
    • INR: in hospital daily after 2nd or 3rd dose; when in therapeutic range for 2 consecutive days, monitor 2-3X wk for 1-2 wk then less frequently, depending on stability of INR results
    • Outpatient: Moitor every few days until stable dose then periodically thereafter, depending on stability of INR results
    • BLACK BOX WARNING: Bleeding gums, petechiae, ecchymosis, black tarry stools, hematuria; fatal hemorrhage can occur
    • **Fever, skin rash, and urticaria
  105. For warfarin (Rx), Coumadin, what is involved with the NURSING PERFORM/PROVIDE?
    Storage in tight container
  106. For warfarin (Rx), Coumadin, what is involved with the NURSING EVALUATION?
    Therapeutic response: decrease in deep venous thrombosis
  107. For warfarin (Rx), Coumadin, what is involved with the NURSE TEACHING PATIENT/FAMILY?
    • To avoid OTC preparations that may cause serious product interations unless directed by prescriber
    • To carry emergency ID identifying product taken
    • About the importance of compliance
    • To report any signs of bleeding, gums, under skin, urine, stools; to use soft bristle toothbrush to avoid bleeding gums; to use electric razor
    • To avoid hazardous activities (football, hockey, skiing), dangerous work
    • About the importance of avoiding unusual changes in vitamin intake, diet, or lifestyle
    • To inform all health care providers of anticoagulant intake
  108. For warfarin (Rx), Coumadin, what is the treatment for an overdose?
    Administer vitamin K
  109. What are antibiotics used for?
    Treatment and prophylaxis of various bacterial infections
  110. Define prophylaxis
    Action taken to prevent disease, by specified means or against a specified disease
  111. What does a bactericidal do?
    • Kills bacteria
    • EXAMPLE: like homicidal
  112. What does a bacteriostatic do?
    Inhibits the growth of susceptible pathogenic bacteria
  113. What does a C&S test do?
    Determines which antibiotic is effective against a specific organism.
  114. What does "symptomatic relief as microorganisms are eradicated" mean, in regard to a antibiotic?
    If the antibiotic is working, then such symptoms as fever, melaise, redness, swelling, exudate production, etc. should disappear.
  115. True or False
    Antibiotics will work against a virus.
    False
  116. True or False
    Antibiotics will work against a fungi.
    False
  117. What is a bacteria?
    A one celled organism
  118. Define bacillus
    Rod shaped
  119. Define Cocci
    Round shaped
  120. List some of the groups of antibiotics (antiinfectives).
    • Penicillins
    • Cephalosporins
    • Aminoglycosides
    • Sulfonamines
    • Tetracyclines
    • Monobactam
    • Erythromycin
    • Quinolones
  121. What were the first antibiotics to be developed?
    • Penicillins
    • Cephalosporins
  122. What type of antiinfectives are penicillins and cephalosporins?
    Bacteriocidal
  123. People who are allergic to penicillin may also be sensitive to __________?
    Cephalosporins
  124. What is a common penicillin medication that is prescribed as an antiinfective?
    amoxicillin (Rx) Gen-Amoxicillin, Moxatag
  125. What is a common Cephalosporin medication that is prescribed as an antiinfective?
    cephadroxil (Rx) Keflex
  126. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is the functional class?
    Antiinfective, antiulcer
  127. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is the chemical class?
    Aminopenicillin
  128. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is the action?
    • Interferes with cell wall replication of susceptible organisms: The cell wall, rendered osmotically unstable, swells and bursts from osmotic pressure
    • Bactericidal: Lysis mediated by bacterial cell wall autolysins
  129. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the uses?
    • Broad spectrum drug
    • Treatment of skin, respiratory, GI, GU infections, otitis media, gonorrhea; for gram-positive cocci (staphylococcus aureaus, Streptococcus pyogenes, Streptococcus . . . ) gram-negative cocci, gram -positive bacilli, gram-negative bacilli . . . etc.
  130. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the unlabeled uses?
    Lyme disease, anthrax treatment and prophylaxis, cervicitis, Chlamydia trachomatis, dental abscess/infection, dyspepsia, gastric ulcer, nongonococcal urethritis (NGU), periodontitis, typhoid fever
  131. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the contraindications?
    Hypersensitivity to penicillins
  132. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the contraindication precautions?
    Pregnancy (B), breastfeeding, neonates, hypersensitivity to cephalosporins, sever renal disease actue lyphocytic leukemia, mononucleosis, phenylketonuria
  133. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the administration points?
    • PO route 
    • Suspension: Shake well before each dose; may be used alone, mixed in drinks; use immediately; discard unused portion after 14 days
    • Give: Around the clock
    • Caps: May be emptied, mixed with liquids if needed
    • Extended Release: Do not crush, chew, or break
  134. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the side effects on the CNS?
    • Common: NONE
    • Life threatening: Seizures
  135. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the side effects on the GI?
    • Common: Nausea, vomiting, diarrhea
    • Life threatening: Pseudomembranous colitis
  136. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the side effects on the HEMA?
    • Common: NONE
    • Life threatening: Bone marrow depression, granulocytopenia, hemolytic anemia
  137. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the side effects on the INTEG?
    • Common: Urticaria and rash
    • Life threatening: NONE
  138. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the side effects on the SYST?
    • Common: NONE
    • Life threatening: Anaphylaxis, respiratory distress, serum sickness, Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis
  139. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what are the pharmacokinetics?
    • Peak: 2 hr
    • Duration: 6-8 hr
    • Half-life: 1-1 1/3 hr
    • Metabolized: In the liver
    • Excreted: In the urine
    • Crosses: Placenta
    • Enters: Breastmilk
  140. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is involved in the NURSING ASSESMENT?
    • I&O ratio; report hermaturia, oliguria because penicillin in high doses is nephrotoxic (kidneys)
    • Hepatic studies: AST, ALT
    • Blood studies; WBC, RBC, Hgb, Hct, bleeding time (see HEME side effects)
    • Renal studies: Urinalysis, protein, blood, BUN, creatinine (Nephrotoxic)
    • C&S before product therapy: Product may be given as soon as the culture is taken
    • Pseudomembranous colitis: Bowel pattern before, during treatment; diarrhea, cramping, blood in stools; report to prescriber (see GI side effects)
    • Skin eruptions: After administration of penicillin to 1 wk after discontinuing product (stop, assess, and call)
    • Respiratory status: Rate, character, wheezing, tightness in chest
    • Anaphylaxis: Rash itching, dyspnea, facial/laryngeal edema
  141. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is involved in the NURSING PERFORM/PROVIDE?
    • Adequate intake of fluids (2L) during diarrhea episodes
    • Scratch test to assess allergy after securing order from prescriber; usually done when penicillin is only product of choice
    • Storage in tight container; after reconstituting, oral susp refrigerated for 14 days
    • ****MAKE SURE YOU HAVE THESE - IN CASE OF ALLERGIC REACTION: Adrenaline, suction, tracheostomy set, endotracheal intubation equipment on unit
  142. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is involved in the NURSING EVALUATION?
    Therapeutic response: absence of infection; prevention of endocarditis (inflammation of heart chambers and/or valves), resolution of ulcer symptoms
  143. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is involved in the NURSE TEACHING PATIENT/FAMILY?
    • That caps may be opened, contents taken with fluids; that chewable form is available; to take as prescribed, not to double dose
    • All aspects of product therapy: to complete entire course of medication to ensure organism death (10-14 days); that culture may be taken after completed course of medication
    • To use nonhormonal form of contraception (can render ineffective!)
    • To report sore throat, fever, fatigue, diarrhea (superinfection or agranulocytopenia), blood in stool, abdominal pain (pseudomembranous colitis), decreased urinary output.
    • That product must be taken in equal intervals around the clock to maintain blood levels; to take without regard to food
    • ****To wear or carry emergency ID if allergic to penicillins
  144. For amoxicillin (Rx), Gen-Amoxicillin, Moxatag, what is treatment for an OVERDOSE?
    • Withdraw product
    • Maintain airway
    • Administer EPINEPHrine
    • Aminophylline
    • O2
    • IV Corticosteroids
  145. For cefadroxil (Rx), Keflex, what is the functional class?
    Antiinfective
  146. For cefadroxil (Rx), Keflex, what is the chemical class?
    Cephalosporin (1st generation)
  147. For cefadroxil (Rx), Keflex, what is the action?
    Inhibits bacterial cell wall synthesis; renders cell wall osmotically unstable, leads to cell death; lysis mediated by cell wall autolytic enzymes
  148. For cefadroxil (Rx), Keflex, what are the uses?
    Gram-negative bacilli: Escherichia coli, Proteus mirabilis, Klebsiella (UTI only); gram-positive organisms: Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus; upper, lower respiratory tract, urinary tract, skin infections; otitis media, tonsillitis; UTIs
  149. For cefadroxil (Rx), Keflex, what are the contraindications?
    Hypersensitivity to cephalosporins, infants < 1 mo
  150. For cefadroxil (Rx), Keflex, what are the contraindication precautions?
    Pregnancy (B), breastfeeding, hypersensitivity to penicillins, renal disease
  151. For cefadroxil (Rx), Keflex, what are the administration points?
    • For 10-14 days to ensure organism death, prevent superinfection
    • With food if needed for GI symptoms
    • Shake suspension, refrigerate, discard after 2 wk
    • After C&S completed
  152. For cefadroxil (Rx), Keflex, what are the side effects for the CNS?
    • Common: NONE
    • Life threatening: Seizures
  153. For cefadroxil (Rx), Keflex, what are the side effects for the GI?
    • Common: Diarrhea, anorexia
    • Life threatening: Pseudomembranous colitis
  154. For cefadroxil (Rx), Keflex, what are the side effects for the GU?
    • Common: NONE
    • Life threatening: Nephrotoxicity and renal failure
  155. For cefadroxil (Rx), Keflex, what are the side effects for the HEMA?
    • Common: NONE
    • Life threatening: Leukopenia, thrombocytopenia, agranulocytosis, neutropenia, lymphocytosis, eosinophilia, pancytopenia, hemolytic anemia
  156. For cefadroxil (Rx), Keflex, what are the side effects for the SYST?
    • Common: NONE
    • Life threatening: Anaphylaxis, serum sickness, Stevens-Johnson syndrome
  157. For cefadroxil (Rx), Keflex, what are the MAJOR side effects?
    Blood issues!!
  158. For cefadroxil (Rx), Keflex, what are the pharmacokinetics?
    • Peak: 1 - 1 1/2 hr
    • Duration: 12-24 hr
    • Half-life: 1-2 hr
    • 20%: Bound by plasma proteins
    • Crosses: Placenta
    • Excreted: In breastmilk
  159. For cefadroxil (Rx), Keflex, what are the interactions?
    Increase: prothrombin time - anticoagulants; use cautiously
  160. For cefadroxil (Rx), Keflex, what is involved in the NURSING ASSESSMENT?
    • Sensitivity to penicillin and other cephalosporins
    • Nephrotoxicity: Increased BUN, creatinine
    • Urine output: If decreasing, notify prescriber
    • I&O daily
    • Blood studies: AST, ALT, CBC, Hct, bilirubin, LDH, alk phos, Coombs' test monthly if patient is on long-term therapy
    • Electrolytes: K, Na, Cl monthly if patient is on long-term therapy
    • Pseudomembranous colitis: bowel pattern daily; if severe diarrhea occurs, product should be discontinued
    • Anaphylaxis: rash, urticaria, pruritus, chills, fever, joint pain; angioedema; may occur a few days after therapy begins; discontinue product, notify prescriber immediately, keep emergency equipment nearby
    • Bleeding: ecchymosis, bleeding gums, hematuria, stool guaiac daily
    • OVERGROWTH OF INFECTION: perineal itching, fever, malaise, redness, pain, swelling, drainage, rash, diarrhea, change in cough, sputum
  161. For cefadroxil (Rx), Keflex, what is involved in the NURSING EVALUATION?
    Therapeutic response: decreased symptoms of infection, negative C&S
  162. For cefadroxil (Rx), Keflex, what is involved in the NURSE TEACHING PATIENT/FAMILY?
    • To use yogurt or buttermilk to maintain intestinal flora, decrease diarrhea
    • To take all medication prescribed for length of time ordered
    • To report sore throat, bruising, bleeding, joint pain (may indicate BLOOD  DYSCRASIAS [rare]); diarrhea with mucus, blood (may indicate PSEUDOMEMBRANOUS COLITIS)
  163. For cefadroxil (Rx), Keflex, what is involved in the TREATMENT OF ANAPHYLAXIS?
    • EPINEPHrine
    • Antihistamines
    • Resuscitate if needed
  164. What are the characteristics of Macrolides and Fluorquinolone antiinfectives (antibiotics)?
    • Bacteriostatic (may be bactericidal)
    • Broad spectrum
    • Used for client's who are sensitive to penicillin
  165. For azithromycin (Rx) Zithromax, Z-pak, what is the functional class?
    Antiinfective
  166. For azithromycin (Rx) Zithromax, Z-pak, what is the chemical class?
    macrolide (azalide)
  167. For azithromycin (Rx) Zithromax, Z-pak, what is the action?
    Binds to 50S ribosomal subunits of susceptible bacteria and supresses protein synthesis; much greater spectrum of activity than erythromycin; more effective against gram-negative organisms
  168. For azithromycin (Rx) Zithromax, Z-pak, what are the uses?
    Mild to moderate infections of the upper respiratory tract, lower respiratory tract; uncomplicated skin and skin structure infections caused by Moraxella catarrbalis, Streptococcus pneumoniae, Streptococcus pyogenes . . .
  169. For azithromycin (Rx) Zithromax, Z-pak, what are the contraindications?
    Hypersensitivity to azithromycin, erythromycin, and any macrolide
  170. For azithromycin (Rx) Zithromax, Z-pak, what are the contraindication precautions?
    Pregnancy (B), breastfeeding; geriatric patients; renal/hepatic/cardiac disease; <6 mo for otitis media; <2 yr for pharyngitis, tonsillitis
  171. For azithromycin (Rx) Zithromax, Z-pak, what are the side effects of the GI?
    • Common: Nausea, vomitting, diarrhea
    • Life threatening: Hepatotoxicity, CHOLESTATIC JAUNDICE, pseudomembranious colitis
  172. For azithromycin (Rx) Zithromax, Z-pak, what are the side effects of the SYST?
    • Common: NONE
    • Life threatening: ANGIOEDEMA (hives under the skin [dermis]), Stevens-Johnson syndrome, toxic epidermal necrolysis
  173. For azithromycin (Rx) Zithromax, Z-pak, what are the pharmacokinetics?
    • PO
    • Peak: 2-4 hr
    • Duration: 24 hr
    • IV
    • Peak: End of inf
    • Duration: 24 hr
    • Half-life: 11-57 hr
    • Excreted: In bile, feces, urine, primarily as unchanged product
    • NOTE: May be inhibitor of P-glycoprotein
  174. For azithromycin (Rx) Zithromax, Z-pak, what are the INTERACTIONS?
    • Increase: Toxicity - ergotamine
    • INCREASE: Dysrhythmias - pimozide: fatal reaction
  175. For azithromycin (Rx) Zithromax, Z-pak, what is involved in the NURSING ASSESSMENT?
    • I&O ratio; report hematuria, oliguria with renal disease
    • Hepatic studies: AST, ALT, CBC with differential
    • Renal studies: urinalysis, protein blood
    • C&S before product therapy; product may be taken as son as culture is taken; C&S may be repeated after treatment
    • SERIOUS SKIN REACTIONS: Stevens-Johnson syndrome, toxic epidermal necrolysis, ANGIOEDEMA; discontinue if rash develops, treat symptomatically
    • SUPERINFECTION: sore throat, mouth, tongue; fever, fatigue, diarrhea, ANOGENITAL PRURITUS (itching at the anus and genetils)
    • PSEUDOMEMBRANOUS COLITIS: diarrhea, abdominal pain, fever, fatigue, anorexia; obtain CBC, serum albumin
    • Bowel pattern before during treatment
    • Respiratory status: rate, character; wheezing, tightness in chest: discontinue product
  176. For azithromycin (Rx) Zithromax, Z-pak, what is involved in the NURSING PERFORM/PROVIDE?
    Storage at room temperature
  177. For azithromycin (Rx) Zithromax, Z-pak, what is involved in the NURSING EVALUATION?
    Therapeutic response: C&S negative for infection; decreased signs of infection
  178. For azithromycin (Rx) Zithromax, Z-pak, what is involved in the NURSE TEACHING PATIENT/FAMILY?
    • To report sore throat, fever, fatigue, severe diarrhea, anal/genital itching 9may indicate superinfection)
    • Not to take aluminum-magnesium-containing antacids simultaneously with this product (PO)
    • To notify nurse of diarrhea, dark urine, pale stools; yellow discororation of eyes, skin; severe abdominal pain (LIVER FAILURE - JAUNDICE)
    • To complete dosage regimen
  179. For ciprofloxacin (Rx), Cipro, what is the functional class?
    Antiinfective - broad spectrum
  180. For ciprofloxacin (Rx), Cipro, what is the chemical class?
    Fluoroquinolone
  181. For ciprofloxacin (Rx), Cipro, what is the action?
    Interferes with conversion of intermediate DNA fragments into high-molecular-weight DNA in bacteria; DNA gyrase inhibitor
  182. For ciprofloxacin (Rx), Cipro, what are the uses?
    Infection caused by susceptible Escherichia coli, Enterobacter cloacae, Proteus mirabilis . . . .
  183. For ciprofloxacin (Rx), Cipro, what are the contraindications?
    Hypersensitivity to quinolones
  184. For ciprofloxacin (Rx), Cipro, what are the contraindication precautions?
    • Pregnancy (C), breastfeeding, children, geriatric patients, renal disease, epilepsy, QT prolongation, HYPOKALEMIA
    • BLACK BOX WARNING: Tendon pain/rupture, TENDINITIS
  185. For ciprofloxacin (Rx), Cipro, what are the ADMINISTRATION points?
    Do not use theophylline with this product, will cause toxicity.
  186. For ciprofloxacin (Rx), Cipro, what are the side effect on the CNS?
    • Common: Headache, restlessness
    • Life threatening: Seizures
  187. For ciprofloxacin (Rx), Cipro, what are the side effect on the GI?
    • Common: nausea, diarrhea
    • Life threatening: Pseudomembranous colitis
  188. For ciprofloxacin (Rx), Cipro, what are the side effect on the HEMA?
    • Common: NONE
    • Life threatening: BONE MARROW DEPRESSION
  189. For ciprofloxacin (Rx), Cipro, what are the side effect on the INTEG?
    • Common: Rash
    • Life threatening: Toxic epidermal necrolysis
  190. For ciprofloxacin (Rx), Cipro, what are the side effect on the MISC?
    • Common: NONE
    • Life threatening: Anaphylaxis, Stevens-Johnson syndrome
  191. For ciprofloxacin (Rx), Cipro, what are the side effect on the MS?
    • Common: NONE
    • Life threatening: TENDON RUPTURE
  192. For ciprofloxacin (Rx), Cipro, what are the pharmacokinetics?
    • Peak: 1 hr
    • Half-life: 3-4 hr
    • Excreted: In urine as active product
    • Metabolites: 35-40%
    • Protein binding: 20-40%
  193. For ciprofloxacin (Rx), Cipro, what is involved in the NURSING ASSESSMENT?
    • Infection: WBC, temperature before treatment, periodically
    • CNS symptoms: headache, dizziness, fatigue, insomnia, depression
    • Renal, hepatic studies: BUN, creatinine, AST, ALT
    • I&O ratio: urine pH < 5.5 is ideal
    • ANAPHYLAXIS: Fever, flushing, rash, urticaria, pruritus, dyspnea (Must take a temperature first!)
    • NOTE: For tendon pain, especially in children
  194. For ciprofloxacin (Rx), Cipro, what is involved in the NURSING PERFORM/PROVIDE?
    Limited intake of alkaline foods, products: milk, dairy products, alkaline antacids, sodium bicarbonate; caffeine intake if excessive cardiac or CNS stimulation
  195. For ciprofloxacin (Rx), Cipro, what is involved in the NURSING EVALUATION?
    Therapeutic response: decreased pain, frequency, urgency, C&S; absence of infection
  196. For ciprofloxacin (Rx), Cipro, what is involved in the NURSE TEACHING PATIENT/FAMILY?
    • Not to take any products tht contain magnesium, calcium (such as antacids), iron, aluminum with this product or within 2 hr of product
    • To report tendon pain, chest pain, palpitations
    • To ambulate, perform activities with assistance if dizziness occurs
    • To complete full course of product therapy; not to double or miss doses
    • To contact prescriber if adverse reaction occurs, if inflammation or pain in tendon occurs
    • TO FREQUENTLY RINSE MOUTH; USE SUGARLESS CANDY, GUM FOR DRY MOUTH
    • NOTE: To contact prescriber if taking theophylline (used to prevent and treat wheezing, shortness of breath, and difficulty breathing caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air passages in the lungs, making it easier to breathe.)
  197. For gentamicin (Rx), what is the functional class?
    • Antiinfective
    • BIG GUNS!!!
  198. For gentamicin (Rx), what is the chemical class?
    Aminoglycoside
  199. For gentamicin (Rx), what is the action?
    Interferes with protein synthesis in bacterial cell by binding to ribosomal subunit, thus causing misreading of genetic code; inaccurate peptide sequence forms in protein chain, thereby causing bacterial death
  200. For gentamicin (Rx), what are the uses?
    Sever systemic infections of CNS, respiratory, GI, urinary tract, bone, skin, soft tissues caused by susceptible strains of Pseudomonas aeruginosa, Proteus, Klebsiella, Serratia, Escherichia coli, Enterobacter, Citrobacter, Staphylococcus, Shigella, Salmonella, Acinetobacer, Bacillus anthracis, acute PID
  201. For gentamicin (Rx), what are the contraindications?
    • Hypersensitivity to this product, other aminoglycosides; fungal/viral/mycobacterial infection
    • BLACK BOX WARNING: Pregnancy (D), severe renal disease
  202. For gentamicin (Rx), what are the contraindication precautions?
    • Breastfeeding, neonates, geriatric patients
    • BLACK BOX WARNING: Mild renal disease, hearing deficits, myasthenia gravis, Parkinson's disease, infant botulism
  203. For gentamicin (Rx), what are the side effects on the CNS?
    • Common: NONE
    • Life threatening: Seizures, neurotoxicity
  204. For gentamicin (Rx), what are the side effects on the EENT?
    • Common: DEAFNESS
    • Life threatening: OTOTOXICITY
  205. For gentamicin (Rx), what are the side effects on the GI?
    • Common: Nausea, vomitting, anorexia
    • Life threatening: Hepatic necrosis
  206. For gentamicin (Rx), what are the side effects on the GU?
    • Common: NONE
    • Life threatening: Oliguria, hematuria, renal damage, azotemia (excessive amounts of toxic wastes not filtered), renal failure, nephrotoxicity
  207. For gentamicin (Rx), what are the side effects on the HEMA?
    • Common: NONE
    • Life threatening: Agranulocytosis, thrombocytopenia, leukopenia
  208. For gentamicin (Rx), what are the side effects on the INTEG?
    • Common: Rash
    • Life threatening: NONE
  209. For gentamicin (Rx), what are the pharmacokinetics?
    • Metabolized: No
    • Excreted: Unchanged in urine
    • Crosses: Placental barrier
    • IM
    • Onset: Rapid
    • Peak: 1-2 hr
    • IV
    • Onset: Immediate
    • Peak: 1-2 hr
    • Infants: 6-7 hr
    • Duration: 6-8 hr
  210. For gentamicin (Rx), what is involved with the NURSING ASSESSMENT?
    • BLACK BOX WARNING
    • NEUROMUSCULAR DISEASE (MYASTHENIA GRAVIS, PARKINSON'S DISEASE, INFANT BOTULISM): Paresthesias, tetany, positive Chvosteks's/Trousseau's signs (HYPOcalciumia), confusion (adults), tetany, muscle weakness (infants); correct electrolyte imbalance
    • Weight before treatment; calculation of dosage is usually based on ideal body weight but may be calculated on actual body weight
    • BLACK BOX WARNING
    • RENAL DISEASE: I&O ratio, urinalysis daily for proteinuria, cells, casts; report sudden change in urine output; urine pH if product is used for UTI; urine should be kept alkaline; urine for CCr testing, BUN, serum cratinine; lower dosage should be given with renal impairment (CCr <80 ml/min); toxicity is increased in patients with decreased renal function of high doses are given
    • VS during inf; watch for hypotension, change in pulse
    • IV site for thrombophlebitis, including pain, redness, swelling q30min, change site if needed, discontinue, apply warm compresses to site
    • SERUM PEAK DRAWN AT 30-60 MIN AFTER IV INF OR 60 MIN AFTER IM INJECTION AND TROUGH LEVEL DRAWN JUST BEFORE NEXT DOSE: Blood level should be 2-4 times bacteriostatic level; peak (5-10 mcg/ml), trough (0.5-2 mcg/ml), depending on type of infection
    • BLACK BOX WARNING:
    • HEARING DEFICITS: Eighth cranial nerve dysfunction by audiometric testing; also ringing, roaring in ears, vertigo; assess hearing before, during, after treatment
    • Dehydration: high specific gravity, decrease in skin turgor, dry mucous membranes, dark urine
    • OVERGROWTH OF INFECTION: fever, malaise, redness, pain, swelling, perineal itching, diarrhea, stomatitis, change in cough or sputum
    • C&S before starting treatment to identify infecting organism
    • VESTIBULAR DYSFUNCTION: nausea, vomiting, dizziness, headache; product should be discontinued if severe
    • Inj sites for redness, swelling, abscesses; use warm compresses at site
  211. For gentamicin (Rx), what is involved with the NURSING PREFORM/PROVIDE?
    • Adequate fluids of 2-3 L/day unless contraindicated to prevent irritation of tubules
    • Supervised ambulation, other safety measures with vestibular dysfunction
  212. For gentamicin (Rx), what is involved with the NURSING EVALUATION?
    Therapeutic response: absence of fever, draining wounds, negative C&S after treatment
  213. For gentamicin (Rx), what is involved with the NURSE TEACHING PATIENT/FAMILY?
    • To report headache, dizziness, symptoms of overgrowth of infection, renal impairment
    • To report loss of hearing: ringing, roaring in the ears, feeling of fullness in the head
  214. What are the NURSING CONSIDERATIONS for antibiotic agents and increasing the therapeutic effects?
    • 1. Assess for s/s infection prior to and throughout therapy
    •  2. Advise patient to notify healthcare preofessional if symptoms donot improve or if they worsen
    •  3. Obtain C&S prior to initiating therapy - first dose may be given prior to receiving results
    •  4. Handle/store/administer drug, per manufacturer guidelines
    •  5. Monitor lab values, as indicated
    •  6. Most antibiotics should be administered around the clock to maintain herapeutic serum levels
    •  7. Stress importance of completing full course of therapy
  215. What are the NURSING CONSIDERATIONS for antibiotic agents and decreasing the adverse effects?
    • Determine previous hypersensitivities
    • Be aware of cross-sensitivities (ex, penicillins & cephalosporins)
    • Advise pt to report signs of superinfection, allergy, serious side effects
    • Prophylactic yogurt, acidophilus
    • Mouth care/ice chips if stomatitis occurs
    • maintain adequate hydration
    • Compresses/gentle massage to painful injections sites

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