Short answer question (2 points each) 6. Compare the activity of the beta-lactam

Question

Short answer question (2 points each)

6. Compare the activity of the beta-lactam antibiotics and the aminoglycosides

7. Nephrotoxicity and ototoxicity are serious side effects of the aminoglycosides. Describe these conditions. Describe two nursing interventions that will reduce the incidence of these conditions.

8. What foods and drugs interfere with absorption of oral tetracycline? How can interference be prevented or minimized?

9. Describe “red man syndrome”. What is the primary nursing consideration in preventing this effect of Vancomycin administration?

10. Increased drug resistance has complicated the use and usefulness of antibiotics. List 3 guidelines to decrease the chance of resistance. Antimicrobial scenarios (5 points each)

11. Mrs. Laura Quinn has telephoned the pediatric physician’s office stating that she has received word from her daughter’s school that she has head lice. Mrs. Quinn states that she is “totally embarrassed,” that “we are clean people,” and that she does not understand how such a thing could happen to her daughter. She has been instructed to obtain a topical solution of permethrin to treat the condition. a. How should the nurse respond to Mrs. Quinn’s embarrassment and to her statement that “we are clean people”? b. Discuss the instructions that the nurse should give Mrs. Quinn regarding the use of permethrin (include possible cross-sensitivities, dosage, frequency). What additional steps should Mrs. Quinn take in order to eliminate the head lice?

12. Frances Yin is a 78-year-old patient who has a history of chronic obstructive pulmonary disease. She has come to the medical clinic for a routine visit to monitor her respiratory status. Her medical history also includes rheumatoid arthritis. Her drug therapy for the arthritis includes disease-modifying antirheumatic drugs (DMARDs), which inhibit her immune system. Currently, an epidemic of influenza A is occurring in her geographic area. Mrs. Yin’s age, chronic pulmonary disease, and immunodeficiency place her in the high-risk category. Her primary care provider has recommended that she take the influenza A vaccine and a prophylactic course of amantadine. a. Mrs. Yin asks why she needs the influenza vaccine. She states, “I took one last year. Won’t that be enough? Why do I need one every year? Those things aren’t 100% effective anyway.” How should the nurse respond? b. Describe the potential adverse effects and nursing considerations related to the amantadine that has been prescribed for Mrs. Yin.

Explanation / Answer

ANS 6 –

On comparing a broadspectrum beta lactam against a dissimilar, usually narrowerspectrum beta lactam collective with an aminoglycoside. No strong change in allcause deaths was experiential, but action disappointments were less with solitary beta lactam antibiotic action. An important existence benefit was understood with solitary treatment in educations that complicated contagions of unidentified basis. Other associated one beta lactam against the same beta lactam mutual with an aminoglycoside antibiotic shows in these hearings, no changes between solitary and combination antibiotic treatments remained perceived. General, opposing event charges did not vary amid the study clusters, but renal damage was additional recurrent with the grouping treatment. Mixture treatment did not stop the growth of secondary contagion.

ANS 7 –

Nephrotoxicity induced by aminoglycosides manifests clinically as nonoliguric renal failure, with a slow rise in serum creatinine and a hypoosmolar urinary output developing after several days of treatment. Ototoxicity, which is the second main adverse effect of aminoglycosides and which, in contrast to nephrotoxicity, is irreversible.

Nursing interventions:

-check the eighth cranial nerve for hearing sense

-Check renal function specially BUN for nephrotoxicity

-check normal urine output = 1200 mL/day ( I/O )

-Take complete sequence for 7-10 days as prescribed

-reassure liquids around 3000 mL/day

ANS 8 –

Tetracylines show low effectivesness with milk products, iron supplements, Mg containing laxatives, or antacids.

Precautions:

-Contraindicated for individuals with allergic to tetracyclines,

-Pregnancy (Category D), not recommended

-lactation, babies,

-kids earlier than 8 years

-Use is warned for alcoholics, hepatic or GI disease, sulfite hypersensitivity, and exposure to sunlight

ANS 9 –

Red man syndrome has frequently been related with fast infusion of the first amount of the drug and was originally credited to impurities originate in vancomycin arrangements. Usually, organization for this syndrome includes the upkeep of the dampness of the skin with damp dressing, wet shawls, emollients, etc. The temperature of the figure, equilibrium of the electrolytes, etc. has to be frequently examined. While, superfluous medications are stationary, the individual may be focused with mild topical steroids, antihistamines, antibiotics, etc. In circumstances where the cause fundamental is noticed, management will be typically absorbed at treating that complaint.

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