Question

CASE STUDY

SA, age 6 years, has otitis media. The health care provider ordered amoxicillin 250 mg every 8 hours. The nurse asks SA's parent if SA is allergic to any drugs, and the parent says that SA is allergic to penicillin.

1. What are the similarities and differences in penicillin and amoxicillin? Explain your answer.

2. What nursing action should the nurse take and why. Explain your answer.

The health care provider changed the amoxicillin order to ceftriaxone (Rocephin) 500 mg every 12 hours. The therapeutic dosage for children is 50 to 75 mg/kg/d in 2 divided doses. The child weighs 40 pounds.

3.What are the similarities and differences in amoxicillin and ceftriaxone? Explain your answer.

4.Is the prescribed ceftriaxone dosage for SA within safe parameters? Explain your answer.

5.Explain the significance of the nurse asking about allergies to antibiotics such as penicillin. What is the relationship of penicillin and ceftriaxone in regard to allergies? Explain your answer.

6.What should the nurse include in patient teaching for SA and her parents? Explain your answer.

Answer 1

1) The main difference between amoxicillin and penicillin is that amoxicillin is effective against a wider spectrum of bacteria compared with penicillin. Both amoxicillin and penicillin belong to the class of antibiotics called penicillins.

2) Patients with a history of an allergy to penicillin ,so the nurse needs to inform the primary health care provider before the first dose of the drug is given.

3)Amoxicillin and ceftriaxone are antibiotics used to treat bacterial infections of the middle ear, tonsils, throat, respiratory tract, urinary tract, and skin.

Amoxicillin is also used to treat gonorrhea.

Ceftriaxone is also used to treat pelvic inflammatory disease, bacterial septicemia, bone and joint infections, and meningitis.

Brand names of amoxicillin include Moxatag and Amoxil.

A brand name for ceftriaxone is Rocephin.

Amoxicillin and ceftriaxone belong to different classes of antibiotics. Amoxicillin is a penicillin-type antibiotic and ceftriaxone is a cephalosporin antibiotic

Side effects of amoxicillin and ceftriaxone that are similar include diarrhea, dizziness, nausea, vomiting, and rash.

Side effects of amoxicillin that are different from ceftriaxone include heartburn, sleep problems (insomnia), abdominal pain, itching, confusion, easy bruising, bleeding, and allergic reactions.

Side effects of ceftriaxone that are different from amoxicillin include upset stomach, blood clots, headache, pain or swelling in your tongue, a lump where the medicine was injected, sweating, vaginal itching or discharge, vaginal yeast infection, anemia, changes in taste, or flushing.

4) Ordered dose of ceftriaxone (Rocephin) 500 mg every 12 hours.

The therapeutic dosage for children is 50 to 75 mg/kg/d in 2 divided doses.

The child weighs 40 pounds= 40× 0.45 kg = 18kg

According to therapeutic dose = 50× 18kg - 70×18 kg= 900mg to 1260mg in two divided doses i . e. 450mg to 630mg at a time

So, the prescribed ceftriaxone dosage for SA is within safe parameters.