PHARMACOLOGY MODULE 5

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Which assessment finding in the patient receiving gentamicin would alert the nurse to a possible adverse reaction?

Tinnitus
Diarrhea
Runny nose
White flakey spots on the tongue

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Which assessment finding in the patient receiving gentamicin would alert the nurse to a possible adverse reaction?

Tinnitus
Diarrhea
Runny nose
White flakey spots on the tongue

Tinnitus

--The aminoglycosides are ototoxic and the nurse must assess changes in patients' hearing, balance, and urinary output. Tinnitus may indicate ototoxicity. Diarrhea may occur but is not a sign of adverse reactions, nor is runny nose. White spots on the tongue may indicate superinfection.

The patient has been ordered lincomycin. The patient reports to the nurse that the patient has experienced reduced renal function in the past. The nurse anticipates that the health care provider will take which action?

Place the medication on hold until renal function improves.
Increase the original dosage of the medication.
Decrease the original dosage of the medication.
Continue with the medication as originally ordered.

Decrease the original dosage of the medication.

--Rather than place the medication on hold because of the patient's decreased renal function, the health care provider will likely opt to decrease the originally ordered dosage to accommodate the change in function.

A patient on antibiotic therapy needs trough levels drawn. Which is the most appropriate time for the nurse to draw the trough level?

Ten minutes before administration of the intravenous antibiotic
Thirty minutes after beginning administration of the intravenous antibiotic
Sixty minutes after completion of the intravenous antibiotic infusion
Ninety minutes after the intravenous antibiotic is scheduled to be administered

Ten minutes before administration of the intravenous antibiotic

--Trough levels are drawn just before infusion. Peak serum drug levels should be drawn 30 to 60 minutes after the medication is infused. The nurse should document the time drug administration is started and completed and the exact time a peak and/or trough level is drawn.

While instructing a patient about antibiotic therapy, the nurse explains to the patient that bacterial resistance to antibiotics can occur when what happens?
Select all that apply.

Patients stop taking an antibiotic after they feel better.
Environmental dispersion of antibiotic liquid occurs.
Antibiotics are prescribed according to culture and sensitivity reports.
Antibiotics are prescribed to treat a viral infection.
Antibiotics are taken with water or juice.
Antibiotics are taken with ascorbic acid (vitamin C).

Patients stop taking an antibiotic after they feel better.
Environmental dispersion of antibiotic liquid occurs.
Antibiotics are prescribed to treat a viral infection.

--Not completing a full course of antibiotic therapy can allow bacteria that are not killed but have been exposed to the antibiotic to adapt their physiology to become resistant to that antibiotic. The same thing can occur when bacteria are exposed to antibiotics in the environment or when antibiotics are erroneously used to treat a viral infection.

The nurse is preparing to administer the morning medications, which includes a tetracycline. While preparing to administer the medication, the dietary staff delivers the patient's breakfast tray. Which item on the tray would most concern the nurse?

Coffee
Eggs
Milk
Whole wheat toast

Milk

--Milk and foods high in calcium can inhibit tetracycline absorption. To avoid drug interaction, these should be taken at least 2 hours apart from tetracycline.