Exam 2 Blueprint
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Demonstrate understanding of self-administration of a prescribed oral antibiotic.
- -Take around the clock and finish full course
- _Some meds are taken on an empty stomach and others with food
- -If anti-acids are needed take anti acid 1 hr before or 2 hrs after
- -Do not drink alcohol with meds
- -Do not crush extended release meds
Review the therapeutic uses associated with cephalosporins
- -Prophylaxis for surgery
- -Ear infection
- -Pelvic infections
- -Last 2 generations cross BBB which may treat meningitis.
Summarize the side/adverse effects related to the administration of vancomycin (Vancocin)
- -Infusion reactions (rash, flushing, tachycardia, hypotension)
- -Thromobophlebitis (red line)
Explain the expected pharmacological action associated with the medication classification - Aminoglycosides.
-Inhibits protein synthesis of gram (-) bacteria = cell death
Assess pertinent therapeutic nursing interventions involved with the administration of Gentamicin (Garamycin).
- -Monitor BUN, GFR, creatnine, CBC
- -Monitor peak (after 30 min) and trough levels.
- -Monitor levels
- -Monitor S/S of ototoxicity such as tinnitus.
- -Do not mix with penicillins.
Summarize the nursing evaluation of medication effectiveness of the medication classification - Antimycobacterial (antituberculosis)
- -Clearing of breathing (sounds)
- -No bloody sputum
- -No fever or night sweats
- -Cultures are negative.
Analyze the therapeutic uses of antiviral medications.
- Amantadine - influenza A, resp.viruses, Parkinson's.
- Acyclovir - herpes simplex and varicella zoster virus
Review the side/adverse effects associated with the administration of medications classified as antiprotozoals.
Flagyl - metallic taste, darkening of urine, CNS symptoms (ataxia, numbness in extremities, seizures)
Describe the therapeutic use associated with the antifungal medication Ketoconazole (Nizoral).
Systemic infections and TOPICAL infections.
Explain the expected pharmacological action associated with the medication classification fluoroquinolones.
This inhibits DNA replication by damaging the DNA enzymes.
Assess the therapeutic uses indicated for administrating antimycobacterial (antituberculosis)
Active and latent TB, leprosy
Assess the therapeutic nursing interventions associated with the administration of nitrofurantoin (Macrodantin).
- -CBC (platelets)
- -Monitor creatnine (>40 mL/min)
- -Notify pt of urine for brown discoloration
Explain which medication is the drug of choice for urinary tract infections caused by E.coli.
Summarize the expected pharmacological action of bacteriostatic inhibitors
Slows growth and replication by inhibiting protein synthesis.
Review the side/adverse effects associated with the administration of tetracyclines.
Teeth discoloration, photosensitivity, hepatotoxic, esophageal ulceration, pseudomembranous colitis.
Describe the therapeutic uses of penicillins.
Staph, strep, syphilis, meningitis, prophylaxis, endocarditis w/dental procedures.
Describe three contraindications/precautions associated with the administration of penicillins.
- -allergy to cephalosporins, imipenem, and penicillins
- -cautious with renal impairment
- -hyperkalemia (penicillin G)
List at least four side/adverse effects associated with the administration of cephalosporins and include a rationale (nursing intervention or patient education) for each.
- Pseudomembranous colitis - teach pt to report excessive bloody diarrhea.
- Nephrotoxicity - monitor BUN, GFR creatinine to obtain a baseline and notice impairments.
- Thrombophlebitis with IV infusion - monitor IV site for redness and pain every 2 hours, rotate IV site and apply warm compress if redness is noted.
- Bleeding tendencies - teach pt to use soft bristle toothbrush, avoid physical contact sports, use electric razor. Monitor for bloody gums, easy bruising, and epitaxis (nose bleeding).
- Superinfections like vaginal yeast - teach pt to maintain adequate hygiene, maintain perineal area dry and use cotton underwear.
Explain the terms ototoxicity and nephrotoxicity associated with the administration of aminoglycosides and include a nursing intervention related to prevention of each condition.
- Ototoxicity related to damaging of the 8th cranial nerve as evidence by tinnitus (hearing loss) and vertigo. Obtain a hearing baseline and monitor for tinnitus and hearing loss throughout nursing care. Use cautiously with diuretic medications due to increased ototoxicity. Stop medications if symptoms appear.
- Nephrotoxicity is related to damaging of the kidneys resulting in impaired filtration function. Obtain a baseline from BUN, GFR and creatinine; Maintain patient hydrated 2-3 L of water to prevent toxicity. Monitor I/O.
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