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Health Assessment - Exam 1
Terms in this set (63)
1. Match the following prefix or suffix to its appropriate classification. One classification will be used more than one time.
1. What medication is used for relieving dysuria, frequency and urgency due to a UTI? ________________________. What should the patient be taught about r/t this medication? ________________________________________
urine will be red/oragne
1. What 3 classifications can increase the effectiveness of warfarin? ___________________, ___________________ _____________________
What lab value should be closely monitored? _________________
tetracyclines, cephalosporin, & macrolides
monitor INR lab values
1. Sulfonamides inhibit this vitamin which causes a bacteriostatic action? ______________________.
1. Most antimicrobials can decrease the effectiveness of oral _____________________. What should be taught to the patient? ___________________________________________________________
pt should use alternative birth control methods
1. Which term is used when an antimicrobial inhibits the growth of bacteria? __________________________. Which term is used when it is directly lethal to bacteria? ______________________
1. Name the 4 main drugs used in the treatment regimen of active TB.
isoniazid (INH), rifampin, pyrazinamide, & ethambutol
1. All of these drugs have the potential to cause toxicity in what organ? ______________. Which of these drugs can be used alone to treat those exposed to TB or to treat latent TB? ___________ (initials). What is the duration of treatment for this drug? ________________. What vitamin can become deficient with the use of this drug? Vitamin _______ AKA: ______________________Due to this deficiency, what adverse effect can occur? ________________________________________________
Which of these drugs can cause gouty arthritis? ______________________.
1. Which drug should be stopped if the person experiences optic neuritis? _________________. If this ADR occurs, what symptom is experienced by the patient? _________________________________________
dec. vision and color discrimination
1. Which drug is used in place of rifampin when treating LTBI? ___________
The drug used in place of rifampin if patient is taking antiretrovirals for HIV
is _______________________. Which WBC should be monitored when a
patient is receiving rifabutin? ______________________. What adverse
effect is commonly seen with rifampin? _________________________________________________________
red/orange body secretions
1. TRUE OR FALSE
________________The longer antimicrobials are used, the more effective
they will be.
________________ A suprainfection is when antimicrobials eliminate the
inhibitory effect of normal flora allowing a new second
infection to occur.
________________ phenazopyridine possesses no antibacterial effect and
should not be used more than two days.
________________Antimicrobials can be used to reduce the duration of
the common cold.
________________acyclovir helps prevent transmission of the Herpes virus
________________The long duration of treatment for TB is one main
reason why nonadherence is high.
________________ Multiple drugs are necessary because the bacteria are
more likely to mutate into a resistant form if only one
drug is given.
________________The metabolism of INH is mainly based on genetics.
________________The primary anti-TB drugs are selective for the
Mycobacterium organism and do not destroy the
beneficial normal flora.
________________ INH has bactericidal actions on actively dividing
organisms and bacteriostatic actions on resting
1. What information does a Culture & Sensitivity (C&S) provide:
culture is the process of growing the bacteria
sensitivity is finding the correct antimicrobial
1. What substance is present on the plasma membranes of fungi that is not
found on human plasma membranes which helps antifungals to be
1. Should antimicrobials be started before the C&S is obtained? __________
What about when waiting for results when a severe infection exists? _____
1. What is the best approach in preventing influenza? _____________ How
often is this administered? ______________ How long does this take for
one to obtain adequate immunity after receiving it? _____ weeks.
Is the influenza 100% effective? ______ If not, briefly explain.
___________________________________________. The influenza
vaccine carries the risk of ______________________________
no, because of multiple strains
Gullian Barre Syndrome
1. Neuroaminidase Inhibitors are given to treat active influenza and must be
given within ___________ hours from the onset of symptoms.
1. When should patients be taught to take acyclovir for HSV?
_______________________________ What is the rationale for following
this guideline? ______________________________________
Does this medication cure the virus? ________
when lesion appear
inc. effectiveness and dec. resistance
1. Which 2 types of Hepatitis are vaccines available? _____ & ______. This
means there is no existing vaccine for Hepatitis ________.
A & B
1. What would be administered if a person had a significant exposure to the
Hepatitis B virus? _____________________
1. How many doses are required for Hepatitis A? ______ What is the
time span between these doses? ________ months
How many doses are required for Hepatitis B? _______ months
1. Interferon alpha can be used in the treatment of both Chronic HBV & HCV
but it can cause a serious ADR of severe _______________ with
____________ thoughts. Oral __________________ potentiates
interferon alpha and has no effect on HCV when given alone. This drug can
cause what serious ADR? _________________________ What lab test
should be monitored while on this therapy? ______________________
1. Your patient is taking ganciclovir to treat cytomegalovirus. This drug would
be held if patient's Absolute Neutrophil Count (ANC) is <________/mm3
or platelet count <_____________/mm3
1. What is the most common adverse effect of PCN? ___________________
1. What classification of antimicrobials could cause a cross-sensitivity
reaction in someone with a severe PCN allergy? _____________________
1. What is the lowest concentration of drug that can produce complete
inhibition of bacterial reproduction and growth?
______________________________________________. What are the
initials used to represent this value? ________________
minimum inhibitory concentration
1. What is the lowest concentration of drug that can reduce 99.9% of the
number of bacteria colonies?
minimum bactericidal concentration
1. What enzyme is made by bacteria to counteract PCN's antimicrobial
effect? ___________________. What is the other name?
1. Which are accurate statements? (Place a checkmark next to correct ones)
_________ Narrow-spectrum antimicrobials only work on gram (-) bacteria.
_________ Broad-spectrum antimicrobials promote more resistance.
_________ When someone has a fever but the identifying cause is unknown (FUO), broad-spectrum antimicrobials should be initiated until the results come back so not to delay treatment.
_________ Three reasons why prophylactic antimicrobials should be used is if there is severe neutropenia, recurrent UTIs in young women, and post-exposure to organisms that can cause sexually-transmitted infections.
_________ Combination antimicrobial therapy should be used sparingly such as when there is a mixed infection or to decrease toxicity/ADRs.
__________ As long as the person is feeling better and the fever has subsided, the person can discontinue their antibiotics.
__________ Initial treatment of active TB consists of multi-drug regimen over a prolonged period of time which is the main cause of noncompliance.
__________Treating many viral infections is difficult because the virus alters and replicates inside the host's cells therefore causing a high risk of harming the human.
1. Which oral antifungal, used for onychomycosis, gets incorporated into the
keratin as the nail grows? ________________________________. Which
antifungal can cause negative inotropic effects and should be used with
caution in those with heart failure? ___________________________
Which PO drug is used for the treatment of tinea capitis (ringworm) and is
ineffective against candida species? _____________________________
Which drug is used only for candida species and is available in both topical
and oral forms (suspension & lozenges)? ________________________
1. ______________________ is used with amphotericin which promotes its
entry into fungal cells (amphotericin potentiates this drug's effectiveness).
What 2 cell counts are important to monitor during treatment with this
drug due to the potential for bone marrow suppression?
__________________________ and __________________________
neutrophils (WBC) & thrombocytes (platelets)
1. Two factors that can cause drug penetration to be more challenging are:
____________________________ and _____________________________
BBB & access
1. What 3 antimicrobial classifications are within the beta-lactam family? ___________________, ______________________, __________________
penicillin, cephalosporin, & carbapenem
1. What 2 drugs can potentiate each other but cannot be administered
concurrently (at same time)?
___________________________ and _____________________________
amino-glycoside & penicillin
_________________________ Can cause irreversible ototoxicity, reversible nephrotoxicity and neuromuscular blockade.
1. The patient is taking a sulfonamide to treat a UTI. Additional patient teaching must be done by the nurse if the patient states:
A. "I need to wear sunscreen and protective clothing when out in the sun."
B. "I must drink at least 8-10 glasses of water/day."
C. "It is important that I increase my intake of acidic foods/fluids."
D. "It is vital that I avoid getting injured and stay away from crowds."
2. Which of the following cephalosporin (1st OR 5th) generations:
Has the least activity against gram-negative bacteria/anaerobes _________
Has the highest resistance against beta-lactamases along with easily
crossing the BBB and being distributed into the CSF ___________
1st & 5th
3. A patient asks you why her son has been prescribed a fixed dose of amoxicillin and
clavulanate combination when amoxicillin has been ineffective in the past. The best
response to adding clavulanate is it:
A. aids the amoxicillin with attaching to microbial penicillin-binding proteins
B. affects a wider spectrum of bacteria in case more than 1 microbe exists
C. prevents penicillinase from inactivating the amoxicillin
D. provides additional activity to disrupt the bacterial cell wall
. Tetracycline can cause esophageal ulceration. What can the nurse teach to minimize
the risk of this adverse effect?
A. Take the drug with a full glass of milk
B. Take an antacid 30-60 minutes after taking the tetracyline
C. Lie down for 20-30 minutes once the medication is taken
D. Avoid taking the medication at bedtime
Which of these assessment findings should the nurse report to the prescriber
if identified in a patient taking nitrofurantoin?
C. Brown-colored urine
. Your patient is prescribed the combination drug TMP/SMZ for a UTI. When
reviewing the patient's medication list, what drug would raise concern due to
a potential interaction?
C. acetylsalicylic acid
Which organ can vancomycin cause toxicity?
D. Bone Marrow
Select the major adverse effects of aminoglycosides. ("select all that apply")
A. Ototoxicity (tinnitus, vertigo)
B. Nephrotoxicity (proteinuria, elevated serum creatinine level)
C. Hepatotoxicity (RUQ pain, jaundice)
D. Neuromuscular Blockade (flaccid paralysis, fatal respiratory depression)
E. Bone Marrow Suppression (leukopenia, thrombocytopenia)
A, B, & D
. What type of reaction will occur if penicillin is administered with tetracycline?
To prevent accumulation of PCN in the kidneys, the nurse should always
encourage patients to:
A. use the lowest dose possible
B. increase fruits and vegetables
C. increase fluid intake
D. avoid dairy products
_________________________ Has the potential to cause crystals to form in the urine which can potentially cause obstruction.
Can cause severe disulfiram-like reactions, such as
angina, pulsating headache, diaphoresis and SOB.
Person should avoid alcohol during therapy and up to 72 hours after drug stopped.
_________________________ Nephrotoxicity can be minimized by administering 1L NSS prior to giving this drug.
_________________________ Weakens cartilage which can cause Achilles
tendon rupture - should not be given to those >
60 years or patients taking long-term steroids.
_________________________ Excessive histamine release can occur if this drug
is administered too rapidly causing "red man
_________________________ Can destroy enamel and stain developing teeth by
binding to calcium. Avoid in those <8 yrs. of age
and pregnant/breastfeeding women.
_________________________ If taking these 3 drugs, one must take extra
_________________________ precautions when out in direct sunlight.
tetracycline, fluroquinolones, & sulfonamides
________________________ When given IV too rapidly, it can cause cardiac
arrhythmias by prolonging the QT interval.
_________________________ Has a post-antibiotic effect where the drug's
activity persists for several hours even after serum
levels drop <MBC.
_________________________ To prevent or reduce infusion reactions, the
patient could be pretreated with acetaminophen
_________________________ Can cause staining of certain parts of the brain
due to displaced bilirubin - Known as kernicterus
_________________________ Causes dyspnea, cough & alveolar infiltrates.
_________________________ Suppresses renal excretion of potassium.
________________________ Has a high risk of causing candidiasis and/or
_________________________ Should not be taken with Fe/Ca/Mg/Al products.
_________________________ Used for lower UTIs and has both bacteriostatic
& bactericidal effects. Also can cause hemolytic
anemia if used in those <1 month of age.
_________________________ Used in the treatment of peptic ulcer disease to
_________________________ eradicate H. pylori (2 answers).
tetraclycline & metronidazole
_________________________ Treatment for C. difficile infection (2 answers)
nitrofurantoin & sulfonamides
________________________ Achieves high levels of concentration in the urine
_________________________ (2 answers)
nitrofurantoin & sulfonamides
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