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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
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Review the therapeutic uses associated with cephalosporins
- -Prophylaxis for surgery
- -UTI's
- -Ear infection
- -Pelvic infections
- -Last 2 generations cross BBB which may treat meningitis.
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Summarize the side/adverse effects related to the administration of vancomycin (Vancocin)
- -Ototoxicity
- -Infusion reactions (rash, flushing, tachycardia, hypotension)
- -Thromobophlebitis (red line)
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Explain the expected pharmacological action associated with the medication classification - Aminoglycosides.
-Inhibits protein synthesis of gram (-) bacteria = cell death
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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.
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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.
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Analyze the therapeutic uses of antiviral medications.
- Amantadine - influenza A, resp.viruses, Parkinson's.
- Acyclovir - herpes simplex and varicella zoster virus
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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)
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Describe the therapeutic use associated with the antifungal medication Ketoconazole (Nizoral).
Systemic infections and TOPICAL infections.
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Explain the expected pharmacological action associated with the medication classification fluoroquinolones.
This inhibits DNA replication by damaging the DNA enzymes.
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Assess the therapeutic uses indicated for administrating antimycobacterial (antituberculosis)
Active and latent TB, leprosy
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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
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Explain which medication is the drug of choice for urinary tract infections caused by E.coli.
Bactrim (TMP-SMZ)
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Summarize the expected pharmacological action of bacteriostatic inhibitors
Slows growth and replication by inhibiting protein synthesis.
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Review the side/adverse effects associated with the administration of tetracyclines.
Teeth discoloration, photosensitivity, hepatotoxic, esophageal ulceration, pseudomembranous colitis.
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Describe the therapeutic uses of penicillins.
Staph, strep, syphilis, meningitis, prophylaxis, endocarditis w/dental procedures.
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Describe three contraindications/precautions associated with the administration of penicillins.
- -allergy to cephalosporins, imipenem, and penicillins
- -cautious with renal impairment
- -hyperkalemia (penicillin G)
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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.
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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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