1
Flashcard 1
Front: What are the key considerations a nurse must be aware of before administering medication?
Back: Understanding the medication's purpose, therapeutic effect, potential side/adverse effects, interactions, contraindications, and precautions.
2
Flashcard 2
Front: How does one report an adverse effect of a medication?
Back: Adverse effects are reported to the FDA using the MedWatch program.
3
Flashcard 3
Front: What is the difference between side effects and adverse effects of medication?
Back: Side effects occur at therapeutic doses and don't usually require stopping the medication, while adverse effects are severe, unintended responses that can occur at therapeutic or higher doses and may lead to discontinuation.
4
Flashcard 4
Front: What actions should a nurse take for a client at risk for CNS stimulation?
Back: Take precautions for seizures and advise against driving or operating heavy machinery if CNS depression is expected.
5
Flashcard 5
Front: What are anticholinergic effects and how can a client manage them?
Back: Effects due to muscarinic receptor blockade, causing dry mouth, photophobia, urinary retention, etc. Managed by sipping liquids, wearing sunglasses, and voiding before medication.
6
Flashcard 6
Front: How can orthostatic hypotension be minimized in clients on antihypertensives?
Back: Monitor for dizziness or lightheadedness and advise changing positions slowly.
7
Flashcard 7
Front: What is nephrotoxicity and how is it monitored?
Back: Kidney damage from medications like aminoglycosides; monitored using blood creatinine, BUN levels, and medication peak and trough levels.
8
Flashcard 8
Front: How can hypersensitivity to medications manifest?
Back: Ranges from mild reactions like itching to severe reactions such as anaphylaxis.
9
Flashcard 9
Front: What should a nurse do in the case of a client experiencing anaphylaxis?
Back: Stop medication, establish an airway, administer epinephrine and antihistamines, and monitor hemodynamics.
10
Flashcard 10
Front: Describe extrapyramidal symptoms (EPSs) and their management.
Back: Involuntary movements due to CNS medications; managed with anticholinergic drugs.
11
Flashcard 11
Front: What is the impact of drug-drug interactions on therapeutic and adverse effects?
Back: They can increase therapeutic effects (e.g., using albuterol before glucocorticoids) or adverse effects (e.g., combining diazepam and hydrocodone).
12
Flashcard 12
Front: What should clients know about taking MAOIs and food interactions?
Back: Avoid foods with tyramine to prevent hypertensive crisis.
13
Flashcard 13
Front: What considerations should be made for medication use during pregnancy?
Back: Always determine medication safety during pregnancy using the latest FDA pregnancy labeling guidelines.
14
Flashcards for Chapter 41: Principles of Antimicrobial Therapy
Flashcard 1
Front: What is the goal of antimicrobial therapy?
Back: To use medications to treat infections by selectively targeting microbes without harming host cells.
15
Flashcard 2
Front: What is a superinfection?
Back: An infection that emerges when an antibiotic kills normal flora, allowing resistant organisms to dominate.
16
Flashcard 3
Front: What are the methods of action for antimicrobials?
Back: Destroying cell walls, inhibiting unique enzymes, impairing protein synthesis, disrupting DNA/RNA synthesis, and inhibiting viral replication.
17
Flashcard 4
Front: What distinguishes bactericidal from bacteriostatic medications?
Back: Bactericidal medications kill microbes directly, while bacteriostatic medications slow their growth and rely on the immune system to eliminate them.
18
Flashcard 5
Front: What factors are considered when selecting an antibiotic?
Back: The identity of the infecting organism, the organism's sensitivity to antibiotics, and host factors like infection location, age, allergies, and immune status.
19
Flashcard 6
Front: Why is it important to obtain cultures before starting antimicrobial treatment?
Back: To identify the causative organism and ensure the correct antibiotic is prescribed, preventing resistance.
20
Flashcard 7
Front: How is the sensitivity of a micro-organism to an antimicrobial determined?
Back: Through tests like the disk diffusion test, serial dilution, MIC, and gradient diffusion.
21
Flashcard 8
Front: Why might immunocompromised individuals need strong bactericidal antibiotics?
Back: Their immune systems are less capable of destroying bacteria, necessitating more potent antimicrobial agents.
22
Flashcard 9
Front: Which clients are at increased risk for antimicrobial toxicity?
Back: Infants, due to immature liver and kidney function, and older adults, due to decreased medication metabolism and excretion.
23
Flashcard 10
Front: Why is combination antimicrobial therapy used?
Back: To treat severe infections, prevent resistance, reduce toxicity, and increase treatment efficacy.
24
Flashcard 11
Front: What are some potential issues with combination therapy?
Back: Increased resistance, cost, adverse or toxic reactions, decreased effectiveness, and risk for superinfection.
25
Flashcard 12
Front: When is prophylactic antimicrobial therapy indicated?
Back: Prior to certain surgeries, for individuals with prosthetic heart valves before dental procedures, for those with recurring UTIs, and after exposure to STIs.
26
Flashcard 13
Front: What are key preventive measures to avoid the spread of infection?
Back: Perform hand hygiene, recognize invasive procedures that increase infection risk, maintain up-to-date vaccinations, complete prescribed antimicrobial courses, and use infection-control procedures.
27
Flashcard 1
Front: What is the mechanism of action for penicillins?
Back: Penicillins weaken the bacterial cell wall, leading to bacterial destruction. They belong to the beta-lactam class of antibiotics.
28
Flashcard 2
Front: What types of infections are penicillins used to treat?
Back: Penicillins are used for gram-positive cocci infections, certain gram-negative cocci like Neisseria meningitides, spirochetes like Treponema pallidum (syphilis), and provide prophylaxis against bacterial endocarditis.
29
Flashcard 3
Front: What are the signs of an allergic reaction to penicillin?
Back: Allergic reactions can include dyspnea, skin rash, itching, and hives. Anaphylaxis may present with more severe symptoms like hypotension and difficulty breathing.
30
Flashcard 4
Front: How should you monitor patients receiving high doses of penicillin G potassium?
Back: Monitor cardiac status and electrolyte levels due to the risk of hyperkalemia and dysrhythmias.
31
Flashcard 5
Front: What is the key nursing action before administering penicillin?
Back: Always ask the client about any allergies to penicillin or other beta-lactam antibiotics due to the risk of cross-sensitivity.
32
Flashcard 6
Front: What are cephalosporins and how are they classified?
Back: Cephalosporins are beta-lactam antibiotics that destroy bacterial cell walls, classified into five generations with varying spectrum of activity and beta-lactamase resistance.
33
Flashcard 7
Front: Which generation of cephalosporins is effective against MRSA?
Back: Fifth generation cephalosporins, such as Ceftaroline, are effective against MRSA.
34
Flashcard 8
Front: What are the main complications associated with cephalosporins?
Back: Complications can include allergy, hypersensitivity, anaphylaxis, bleeding tendencies, thrombophlebitis, renal insufficiency, and pseudomembranous colitis.
35
Flashcard 9
Front: What are carbapenems and their main use?
Back: Carbapenems are beta-lactam antibiotics with broad antimicrobial spectra, used for serious infections like pneumonia, peritonitis, and UTIs.
36
Flashcard 10
Front: What are the risks associated with carbapenems?
Back: Allergy, hypersensitivity, gastrointestinal upset, and suprainfection, especially in those with penicillin or cephalosporin allergies.
37
Flashcard 11
Front: What is vancomycin and its primary use?
Back: Vancomycin is an antibiotic used to treat serious infections due to resistant bacteria like MRSA and for antibiotic-associated colitis due to C. difficile.
38
Flashcard 12
Front: What are the common adverse effects of vancomycin?
Back: Ototoxicity, infusion reactions (such as Red man syndrome), injection site pain, thrombophlebitis, and renal toxicity.
39
Flashcard 13
Front: What precautions should be taken when administering vancomycin?
Back: Assess for hearing loss, monitor renal function and vancomycin trough levels, and avoid concurrent use with other ototoxic drugs.
40
**Flashcards for Chapter 43: Antibiotics Affecting Protein Synthesis**
Flashcard 1
Front: What is the action of tetracyclines?
Back: Tetracyclines inhibit micro-organism growth by preventing protein synthesis, making them bacteriostatic.
41
Flashcard 2
Front: When are tetracyclines contraindicated?
Back: They're contraindicated for children under 8 years, during the last half of pregnancy (can stain infant's teeth), and with a history of liver disease.
42
Flashcard 3
Front: What are common side effects of tetracyclines?
Back: GI discomfort, tooth discoloration in children, photosensitivity, and potential for superinfection like pseudomembranous colitis.
43
Flashcard 4
Front: How should tetracyclines be administered?
Back: Take on an empty stomach with a full glass of water; avoid milk products, iron, and antacids within 2 hours of dosage. Minocycline may be taken with food.
44
Flashcard 5
Front: What is the function of macrolides like erythromycin?
Back: Macrolides inhibit protein synthesis (bacteriostatic) or can be bactericidal in high doses, treating a variety of infections.
45
Flashcard 6
Front: What are the side effects and precautions for erythromycin?
Back: Possible GI discomfort, prolonged QT intervals, and ototoxicity. Avoid in clients with liver disease and QT prolongation.
46
Flashcard 7
Front: What are the indications of aminoglycosides like gentamicin?
Back: Aminoglycosides are bactericidal, disrupting protein synthesis in aerobic gram-negative bacilli, and are used for serious infections like E. coli and P. aeruginosa.
47
Flashcard 8
Front: What adverse effects can aminoglycosides cause?
Back: Ototoxicity, nephrotoxicity, neuromuscular blockade, and hypersensitivity reactions.
48
Flashcard 9
Front: How should aminoglycosides be monitored during treatment?
Back: Monitor for signs of ototoxicity and nephrotoxicity, check peak and trough levels for correct dosing, and avoid use with other ototoxic or nephrotoxic drugs.
49
Flashcard 10
Front: What are the contraindications for aminoglycoside use?
Back: Contraindicated in pregnancy (risk of congenital deafness), lactation, and with caution in patients with kidney impairment, hearing loss, or myasthenia gravis.
50
Flashcard 11
Front: How can drug interactions affect tetracycline therapy?
Back: Chelation with calcium, iron, magnesium, and antacids can reduce tetracycline absorption; probenecid delays excretion; doxycycline can increase digoxin toxicity.
51
Flashcard 12
Front: What is important to monitor when administering aminoglycosides?
Back: Hearing function, kidney function (BUN, creatinine), and for signs of muscle weakness.
52
Flashcard 13
Front: What should be considered when administering macrolides?
Back: They can interact with other drugs by inhibiting hepatic metabolism, potentially leading to toxicity. Monitor liver function tests and avoid with drugs that can prolong QT interval.
53
Flashcard 14
Front: What should be avoided when taking tetracyclines?
Back: Avoid taking before bed to reduce esophageal ulceration risk, and use additional contraception as tetracyclines can decrease the effectiveness of oral contraceptives.
54
Flashcard 15
Front: What are the signs of effective antibiotic therapy?
Back: A decrease in infection symptoms (fever, inflammation, pain, adventitious breath sounds) and resolution of the specific infection being treated.
55
Flashcard 1
Front: What is the action of sulfonamides and trimethoprim?
Back: They inhibit bacterial growth by preventing the synthesis of folic acid derivative, tetrahydrofolate, which is essential for DNA, RNA, and protein production.
56
Flashcard 2
Front: For what conditions is trimethoprim-sulfamethoxazole commonly prescribed?
Back: It's used for UTIs, otitis media, chancroid, pertussis, shigellosis, and Pneumocystis jirovecii pneumonia.
57
Flashcard 3
Front: What major side effects can sulfonamides and trimethoprim cause?
Back: They can cause hypersensitivity including Stevens-Johnson syndrome, blood dyscrasias, crystalluria, kernicterus in infants, and hyperkalemia.
58
Flashcard 4
Front: What are contraindications for using sulfonamides and trimethoprim?
Back: Contraindicated in pregnancy and lactation due to risk of kernicterus, and in those with severe allergies to sulfonamides or related drugs like certain diuretics and oral hypoglycemics.
59
Flashcard 5
Front: How should sulfonamides and trimethoprim be administered?
Back: Take on an empty stomach with 8 oz of water. Clients should complete the entire course of therapy and use backup contraception as these antibiotics can decrease the effectiveness of oral contraceptives.
60
Flashcard 6
Front: What is nitrofurantoin and its primary use?
Back: Nitrofurantoin is a broad-spectrum urinary antiseptic with bacteriostatic and bactericidal action used for acute UTIs and prophylaxis for recurrent lower UTIs.
61
Flashcard 7
Front: What adverse effects can nitrofurantoin cause?
Back: GI discomfort, hypersensitivity reactions, blood dyscrasias, peripheral neuropathy, headache, drowsiness, and dizziness.
62
Flashcard 8
Front: How should nitrofurantoin be administered?
Back: Take with food or milk to minimize GI discomfort, avoid in infants under 1 month or during late pregnancy, and complete the full course of therapy.
63
Flashcard 9
Front: What is the action of fluoroquinolones like ciprofloxacin?
Back: They are bactericidal, inhibiting an enzyme necessary for DNA replication, treating a broad spectrum of infections.
64
Flashcard 10
Front: What complications can fluoroquinolones cause?
Back: GI discomfort, Achilles tendon rupture, suprainfection, phototoxicity, and CNS effects like dizziness and headache.
65
Flashcard 11
Front: What should be avoided when taking fluoroquinolones?
Back: Avoid cationic compounds like antacids and dairy products around dosing time, monitor for interactions with theophylline and warfarin, and avoid in children and during pregnancy.
66
Flashcard 12
Front: What is phenazopyridine and its use?
Back: Phenazopyridine is a urinary tract analgesic that relieves symptoms like burning, pain, frequency, and urgency associated with UTIs by acting as a local anesthetic on the urinary tract mucosa.
67
Flashcard 13
Front: What are important nursing considerations for phenazopyridine?
Back: It can cause urine to turn orange-red, which may stain clothing. Use with caution in patients with kidney disease and instruct patients to take with food to minimize GI discomfort.
68
Flashcard 14
Front: What are some complementary therapies for UTIs?
Back: Cranberry juice may prevent UTIs, but isn't effective once an infection has set in. Probiotics can reestablish normal flora after antibiotic use but should be taken a few hours apart from antibiotics to avoid interaction.
69
Flashcard 15
Front: What should be monitored when administering medications for UTIs?
Back: Monitor for a decrease in UTI symptoms like frequency and burning, check for negative urine cultures and lower WBC counts, and evaluate for resolution of GI disturbances.
70
Certainly, here are your flashcards with the requested formatting:
Flashcard 1
Front: Why are multiple medications used to treat tuberculosis?
Back: Multiple medications reduce the chance that the bacteria will become resistant to treatment.
71
Flashcard 2
Front: What is the mechanism of action for isoniazid?
Back: Isoniazid inhibits the growth of mycobacteria by preventing the synthesis of mycolic acid in the cell wall.
72
Flashcard 3
Front: What are the key complications of isoniazid therapy?
Back: Peripheral neuropathy due to pyridoxine (vitamin B6) deficiency and hepatotoxicity.
73
Flashcard 4
Front: What are the contraindications for isoniazid?
Back: Contraindicated for clients with liver disease, during the first trimester of pregnancy or near term, and in breastfeeding.
74
Flashcard 5
Front: How do sulfonamides and trimethoprim work to combat UTIs?
Back: They inhibit bacterial growth by preventing the synthesis of folic acid, essential for bacterial DNA, RNA, and protein production.
75
Flashcard 6
Front: What are the primary uses of metronidazole?
Back: Treatment of protozoal infections and anaerobic bacterial infections, and as prophylaxis in certain surgical procedures.
76
Flashcard 7
Front: What complications can arise from metronidazole treatment?
Back: GI discomfort, darkening of urine, CNS effects like dizziness and headaches, and a possible disulfiram-like reaction with alcohol.
77
Flashcard 8
Front: What are the therapeutic uses of antifungal medications like amphotericin B and ketoconazole?
Back: Treatment of systemic fungal infections like candidiasis, aspergillosis, and nonopportunistic mycoses, and superficial infections like ringworm and nail fungus.
78
Flashcard 9
Front: What complications are associated with amphotericin B therapy?
Back: Infusion reactions, thrombophlebitis, nephrotoxicity, electrolyte imbalance, and bone marrow suppression.
79
Flashcard 10
Front: What is the importance of combination therapy in tuberculosis treatment?
Back: Combination therapy with drugs like isoniazid and rifampin is crucial to prevent the development of resistant strains of M. tuberculosis.
80
Flashcard 11
Front: What are the considerations for administering antituberculosis medications?
Back: They should be taken 1 hour before or 2 hours after meals, and direct observation therapy is recommended to ensure adherence.
81
Flashcard 12
Front: What are the side effects of rifampin?
Back: Discoloration of body fluids, hepatotoxicity, and mild GI discomfort.
82
Flashcard 13
Front: What interactions should be monitored during rifampin therapy?
Back: Rifampin can accelerate the metabolism of warfarin, oral contraceptives, HIV medications, and potentially increase the risk of hepatotoxicity when used with isoniazid and pyrazinamide.
83
Flashcard 1
Front: What is the goal of antiretroviral therapy in HIV treatment?
Back: To reduce the viral load, minimize transmission, and prevent the development of medication resistance.
84
Flashcard 2
Front: Why is HAART used to treat HIV?
Back: HAART, involving three to four HIV medications, reduces virus amount, increases CD4 counts, and minimizes medication resistance.
85
Flashcard 3
Front: How can the risk of developing medication resistance in HIV treatment be minimized?
Back: By taking medications at the same times daily without missing doses.
86
Flashcard 4
Front: What is the mechanism of action for acyclovir and ganciclovir?
Back: They prevent the reproduction of viral DNA, interrupting viral cell replication.
87
Flashcard 5
Front: What are the primary uses of acyclovir and ganciclovir?
Back: Acyclovir is used for herpes simplex and varicella-zoster, while ganciclovir is used for CMV in immunocompromised patients.
88
Flashcard 6
Front: What are the key complications of acyclovir therapy?
Back: Phlebitis at infusion site, nephrotoxicity, and mild discomfort with oral therapy.
89
Flashcard 7
Front: What are the main adverse effects of ganciclovir?
Back: Suppressed bone marrow, fever, headache, nausea, and diarrhea.
90
Flashcard 8
Front: What are the contraindications for antiviral medications like acyclovir and ganciclovir?
Back: Pregnancy, lactation, renal impairment, dehydration, and known hypersensitivity.
91
Flashcard 9
Front: How should antiviral medications like acyclovir be administered to minimize nephrotoxicity?
Back: Infuse IV acyclovir slowly over 1 hour and ensure adequate hydration.
92
Flashcard 10
Front: What is the function of antiretroviral agents like enfuvirtide?
Back: They block HIV from attaching to and entering CD4 T cells.
93
Flashcard 11
Front: What should be monitored in clients taking protease inhibitors like ritonavir for HIV treatment?
Back: Bone loss, diabetes mellitus/hyperglycemia, hepatotoxicity, and elevated blood lipids.
94
Flashcard 12
Front: What are the risks associated with integrase inhibitors such as raltegravir?
Back: Headache, difficulty sleeping, skin rash, liver injury, renal failure, and suicidal ideation.
95
Flashcard 13
Front: What are the key drug interactions with protease inhibitors?
Back: They can raise levels of other medications to toxic levels and decrease the effectiveness of hormonal contraceptives.
96
Flashcard 14
Front: How are antiretroviral NRTIs like zidovudine used in HIV treatment?
Back: As first-line antiretrovirals to reduce HIV manifestations by inhibiting DNA synthesis and viral replication.
97
Flashcard 15
Front: What complications are associated with NRTIs?
Back: Bone marrow suppression, lactic acidosis, nausea, vomiting, diarrhea, pancreatitis, and hepatomegaly/fatty liver.
98
Flashcard 16
Front: How do NNRTIs like efavirenz work against HIV?
Back: They act directly on reverse transcriptase to stop HIV replication.
99
Flashcard 17
Front: What side effects should be monitored in clients on NNRTIs?
Back: Rash, flu-like symptoms, CNS effects (such as dizziness and insomnia), and nausea.
100
Flashcard 18
Front: What precautions should be taken with antiretrovirals like protease inhibitors?
Back: They should be used cautiously in clients with liver disease, diabetes, or heart conditions, and in combination with other HIV medications.
101
Flashcard 19
Front: What interactions and side effects are associated with INSTIs like raltegravir?
Back: Possible interactions with rifampin; side effects include headache, insomnia, and liver injury.
102
Flashcard 20
Front: Why should antiretroviral therapy be strictly adhered to?
Back: To prevent medication resistance and treatment failure, ensuring the effectiveness of HIV management.
103
Flashcard 21
Front: What is the role of complementary therapies in HIV treatment?
Back: Some, like St. John's Wort, can reduce antiretroviral effects, while others like garlic can affect medication levels.
104
Flashcard 22
Front: What alternative therapies should be avoided in HIV treatment and why?
Back: Echinacea due to immune suppression, garlic due to interaction with protease inhibitors, and St. John’s Wort due to reduced antiretroviral effects.
105
Which patient does the nurse identify as being at highest risk for the development of an adverse drug reaction?
A. A 1-month-old patient whose mother has allergies to penicillin, aspirin, and codeine
B. A 16-year-old patient with multiple traumatic injuries who is taking morphine and an antibiotic
C. A 54-year-old patient with multiple sclerosis who has been enrolled in a clinical trial of a new drug
D. An 84-year-old patient with diabetes, heart failure, and hypertension who takes seven prescription medications each
day
D kidney and liver function decrease.
106Question 2
A patient is prescribed a medication that is potentially hepatotoxic. Before administering the medication, it is most important for the nurse to assess what?
A. Blood urea nitrogen and serum creatinine
B. Aspartate aminotransferase and alanine
aminotransferase
C. Prolonged QT interval on the electrocardiogram
D. Serum potassium, serum sodium, and serum
magnesium
B. Hepatotoxic means that it can be damaging to the liver. The nurse should assess the liver function tests of patients who are taking hepatotoxic drugs. When liver cells are injured, two liver enzymes (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) will be elevated.
107Which individual is at the highest risk for a drug-drug interaction?
A. A toddler who is prescribed two antibiotics for a serious infection
B. An adolescent who takes over-the-counter medications for menstrual cramping
C. An adult who takes eight prescription medications for a chronic condition
D. An older adult who takes two prescription medications and a dietary supplement for anxiety
C
108The nurse cares for a patient who is taking a calcium channel blocker for hypertension. The nurse should be most concerned if the patient makes which statement?
A. “I take my medication with a glass of water.”
B. “I eat foods high in fiber to prevent constipation.”
C. “I drink a glass of grapefruit juice each evening.”
D. “I avoid foods such as broccoli and cabbage.”
C
109A patient is prescribed a medication to be taken on an empty stomach. Which statement should the nurse include when providing patient teaching?
A. “Take the medication 1 hour before eating.”
B. “Take the medication with a small glass of water.”
C. “Take the medication before going to bed at night.”
D. “Take the medication 1 hour after a meal.”
A
110Which information should the nurse include when teaching a patient about isoniazid (INH) therapy?
A. Tubercle bacilli cannot develop resistance to isoniazid during treatment.
B. Isoniazid is administered intravenously.
C. An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine.
D. The dose of isoniazid should be lowered if the patient is also taking phenytoin.
C
111Which information should the nurse include when teaching a patient about rifampin therapy?
A. Oral contraceptives are safe to use with rifampin therapy.
B. Contact your healthcare provider immediately if the color of your body fluids changes to reddish orange.
C. Rifampin is safe to use in patients who have hepatic disease.
D. Rifampin may be administered intravenously.
D
112A nurse is planning discharge teaching for a female client who has a new prescription for Trimethoprim-sulfamethoxazole. Which of the following information should the nurse include?
• A. Take the medication even if pregnant
• B. Maintain a fluid restriction while taking it
• C. Take in on an empty stomach
• D. Stop taking it when manifestations subside
take it on an empty stomach
113Question
• Which statement about erythromycin is correct?
A It inhibits cell wall formation of organisms
B It used to treat infections in clients who are allergic to penicillin
C liver function should be monitored when clients are on the drugs
D teach clients to take it with meals usually
E Monitor ECG for this drug
B,C,D,E
114A nurse is preparing to administer cefotaxime (claforan) IV to a client who has a severe infection and has been receiving cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication and should be reported to the provider?
A diaphoresis B diarrhea
C alopecia
D epistaxis
D