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.