Question

The patient diagnosed with pneumonia awaits an order for antibiotic therapy. The patient expresses concern that some antibiotics can cause liver, or kidney damage. This patient has a history of hepatitis C and renal insufficiency. The nurse recognizes which antibiotic classes are contraindicated for this patient? and why?

5. Identify 2 antibiotics that require peak and trough monitoring. When should the nurse draw blood for peak, and trough for these 2 drugs. Identify the normal ranges for the peaks and troughs of these drugs

. 6. The nurse who is being treated for ear infection stated she quickly develops sun burns when exposed to the sun. Based on this information, the nurse suspects the patient is taking which class of antibiotics?

7. A patient is admitted with VRE in urine. Which antibiotic would the nurse expect the doctor to order.

8. A client with wound infection being treated with antibiotic therapy tells the nurse the he has been asked not to take diary products while taking her medication. Which antibiotic is this patient likely receiving, and w

Answer 1

Ans) 5) Peak and trough levels may be ordered for the following antibiotics: amikacin, gentamicin, tobramycin, and vancomycin.

- To assess drug concentrations during the trough phase, blood should be drawn immediately before the next dose. To assess peak levels, the time for drawing depends on the route of administration: Oral: One hour after drug is taken (assumes a half-life of > two hours) IV: 15-30 minutes after injection/infusion.

6) Antibiotics can have side effects, so taking them unnecessarily can make a person feel worse, rather than better. Also, over time, the bacteria that cause some ear infections can become more resistant to antibiotics.

- The sensation of burning in, on or around your ear may cause it to feel swollen, inflamed and tender. It may be warm to the touch. An ear burning sensation is often attributed to otitis media with effusion, in which the Eustachian tube of the middle ear becomes blocked with fluid and infected.

7)

Vancomycin-resistant enterococci (VRE) are a type of bacteria called enterococci that have developed resistance to many antibiotics, especially vancomycin. Enterococci bacteria live in our intestines and on our skin, usually without causing problems. But if they become resistant to antibiotics, they can cause serious infections, especially in people who are ill or weak. These infections can occur anywhere in the body. Some common sites include the intestines, the urinary tract, and wounds.

Vancomycin-resistant enterococci infections are treated with antibiotics, which are the types of medicines normally used to kill bacteria. VRE infections are more difficult to treat than other infections with enterococci, because fewer antibiotics can kill the bacteria.

Be smart about using antibiotics. Know that antibiotics can help treat bacterial infections, but they cannot cure viral infections. Always ask your doctor if antibiotics are the best treatment. And avoid pressuring your doctor into prescribing antibiotics when he or she thinks they won't help you get better.
Always take all your antibiotic medicine as prescribed by your doctor. If you use only part of the medicine, it may not cure your infection. Also, it may cause antibiotic-resistant bacteria to develop.
Do not save any antibiotics, and do not use antibiotics that were prescribed for someone else or for a different problem.

8) Dairy products such as milk, yogurt, and cheese can interfere with certain medications, including antibiotics such as tetracycline, doxycycline, and ciprofloxacin.

- The classic family of antibiotics that cannot be taken with milk are the tetracyclines, because the calcium in the milk binds the antibiotic and prevents gut absorption. For most antibiotics, food results in either a decrease in absorption or has no effect.