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pathophar exam finaL

ch.88-89

QuestionAnswer
SULFONAMIDES=BROAD SPECTRUM INHIBIT TETRAHYDROFOLIC ACID-WITHOUT AFFECTING CELL-AFFECT BACTERIA 1ST SYSTEMIC DRUG TREATS UTI(E.COLI)-CHLAMYDIA
TEACHING-ALL FORM NOT GIVEN: IN NURSING MOTHERS-PREGANT 1ST AND NEAR TERM KERNICTERUS-IN INFANT YOUNGER THAN 2MONTHS OLD SEVERE (BILLURUBIN BUILD UP IN BRAIN NEUROLOGIC DEFICIT) RENAL DAMAGE-CRYSALLURIA- F CAUTION W/ RENAL IMPAIRMENT
TEACHING RENAL DAMAGE-CRYSALLURIA- CAUTION W/ RENAL IMPAIRMENT TAKE WITH FULL GLASS OF WATER FLUID INTAKE-8-10 OZ H2O =1200 ML DAILY URINE ALKALIZATION URINE(NA BICARBONATE) DISCONTINUE AND NOTIFY MD IF HYPERSENSITIVY (RASH)
TEACHING PHOTOSYNTHESIS- Advise patients to avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin HYPERSENSITIVITY-STEVEN-JOHNSON-WIDESPREAD LESIONS (Rash – skin mouth, fever, feel bad, DIB, low BP, High HR)
DRUG INTERACTION CROSS-HYPERSENSITIVITY (SULONYREA-FHYPOGLYCEMICS, LOOP DIURETIC, PEN) METABOLISM-RELATED INTERACTION INTENSIFY EFFECT OF WAFARIN, PHENYTOIN, GLIPIZIDE=REDUCE DOSE
SILVER SULFADIAZINE AND MAFENIDE(TOPICAL SULLFONAMIDES) SUPPRESS BACTERIAL COLONIZATION IN PATIENT WITH 2ND AND 3RD DEGREE-BURNS
TEACHING LOCAL MFENIDE-PAINFUL BURNED NERVE ENDING SULFADIAZINE(RELEASE OF FREE SILVER)-PAIN FREE DO NOT APPLY ON FACE, DISCOLORATION-BLUE-GRAY SYSTEMIC ABSORPTION(THROUGH BREAK IN THE SKIN) MAFENIDE-ACIDOSIS
MICROBIAL RESISTANT GONOCOCCI-GONORRHEA-MENINGOCOCCI-MENINGITIS
TRIMETHOPRIM=BROAD SPECTRUM SUPPRESS BACTERIA SYNTHESIS OF DNA AND RNA TREAT ACUTE AND UNCOMPLICATED UTI(E.COLI) (COMMUNITY ACQUIRED UTI)
TEACHING- COMPLETE COURSE O TREATMENT NOT GIVEN: PREGNANCY -C, AND NURSING MOTHER (CROSS BBB) CAUSE BIRTH DEFECT CAN CAUSE-FOLATE DEFICIENCY (ALCOHOOL) REDUCE DOSE WITH RENAL DYSFUNCTION
TEACHING HEMATOLOGIC -NEUTROPENIA, MEGALOBLASTIC ANEMIA WATCH :SORE THROAT-FEVR-BRUISG OR BLEEDG -CBC- GIVE LEUCOVORIN HYPERKALEMIA- W/HIGHDOSE PT TAKG ACE INHBTR,ALDOSTERNE ANTGNIST, ARBS,K-SPARG DIURETICS, K-SUPPLMNT CHECK k-SERUM 4D AFTER STARTG TRTMNT
Trimethoprim/Sulfamethoxazole ORAL, IV SEVERE REACTIO INHIBIT SEQUENTIAL STEPS IN BACTERI FOLIC SYNTHESIS TREAT: UTIs caused by E. coli and other susceptible organisms, shigellosis, OTITIS MEDIA, PNEUMONIA MORE EFFECTIVE
TEACHING NOT GIVEN: IN 1ST TRIMESTER AND NEAR TERM PREGNANCY, NEWBORN YOUNGER THAN 2 MOUNTH OLD, NURSING MOTHER-FOLATE DEFICIENCY ADR: GI-NV-RASH-HYPERKALEMIA(INCREASE SALT, LESS K)-KERNICTERUS-STEVENS SYNDROMEBLOOD DYSCRASIAS-RENAL DAMAGE
TEACHING CREATINE LAB CREATINE CLEARANCE OF 15-30ML/MIN DECREASE BY 50% , IF FALL BELOW THIS RANGE, DISCONTINUE DRUG USE
URINARY TRACT INFECTIONS (E.COLI) 2ND COMMON INFECTION SEXUALLY ACTIVE YOUNG WOMEN 25-35% ONCE YEARLY OLDER ADULT WOMEN IN NURSING WOMEN
TEACHING E.COLILIVES IN GI TRACT SHORTER URETHRA THAN MEN WIPE FRONT TO BACK COMMONAFTER TAKING BATH VOID AFTER SEXUAL INTERCOUSE
OCCURENCE IN MEN TAKE A THROUGHOUT LOOK AT IT BECAUSE NOT COMMON
UTI PATIENT USUALLY HAVE CYSTITIS UPPER URINARY TRACT (KIDNEY) PYELONEPHRITIS-SICKER-FEVER LOWER(BLADDER AND URETHRA) CYSTITIS-SUPRAPUBIC-DYSURIA-URINARY URGENCY AND FREQUENCY-PYURIA-BACTERIURIA INFECTION IN BLADDER MOVE TO URETERS
UNCOMPLICATED 80% OF UTI-COMMUNITY -ACQUIRED-E.COLI
COMMUNITY -ACQUIRED-E.COLI caused by Klebsiella, Proteus, Enterobacter, Pseudomonas, staphylococci, enterococci, and E. coli
How Do We Know Which m/o GRAIM STAIN-WHAT ORGANISM(GRAM P/M) ANTIBIOTIC WILL WORK OR NOT? URINALYSIS QUICK RESULT= URINEGRAVITY+ORGANISM KETONE-PROTEIN-SUGAR-BLOOD- BACTERIA-NITRITE=INFECTION
How Do We Know Which m/o WHEN RESISTANTTO LOAD MED-OR START NEW COURSE OF TREAMENT CULTURE -WHAT MICROORGANISM IS GROWING IN FLUID? GRAIM STAIN-WHAT ORGANISM(GRAM P/M) IN 72HOURS: SENSITIVITY(WHAT ANTIBIOTIC WILL WORK) GROW ON PETRI DISH TREAT PT IN SEVERE CASE(W/BLOOD, BURNING, FEEL BAD) TGIVE BACTRUM(TMP/SMZ) OR NITROFURANTOIN
WHAT ARE THE TREATMENT OF CHOICE FOR UTI? THEY ARE:TMP/SMZ AND NITROFURANTOIN
ACUTE CYSTITIS TMP/SMZ AND NITROFURANTOIN BLADDER AND URETHRA INFECTION S/S:DYSURIA,PYURIA,BACTERURIA(WBC IN URINE), FRQUENCY AND URGENCY, SUPRAPUBIC DISCOMFORT DRUG UNCOMPLICATED ACUTE CYSTITIS OTD THERAPY SHORT-3DAYS CONVENTIONAL:1WEEK PATIENT WILL BE MORE COMPLIANT
ACUTE UNCOMPLICATED PYELONEPHRITIS(E.COLI) TMP/SMZ IN OLDER ADULTS AND CHILD-BEARING AGE KIDNEY INFECTION +CYSTITIS S/S:CHLILS, FEVER, SEVERE FLANK PAIN, URINARY URGENCY AND FREQUECY, DYSURIA AND PYURIA-BACTERIURIA
ACUTE UNCOMPLICATED PYELONEPHRITIS(E.COLI) 90% IN COMMNITY-ACQUIRED INFECTIONS MILD-TREAT AT HOME WITH ORAL ANTIBIOTICS 10-14D SEVEVERE-TRET AT THE HOSPITAL WITH IV ANTIBIOTICS
COMPLIATED UTI MALES AND FEMALES W, STRUCUTRAL OR FUNCTIONAL ABNORMALITIES OF URINARYTRACT S/S RANGES FROM MILD TO SEVERE UROSEPSIS-SYSTEMIC INFECTION , PT IS SEPTIC DUE TO UTI(OLDER WOMEN). FEVER BACTEREMIA, SEPSTIC 1ST SYMPTOMS IS CONFUSION IN ELDERLY
COMPLIATED UTI DISEASES: PROSTATIC HYPERPLASIA(ENLARGE PROSTATE GLAND) RENAL CALCULI(KIDNEY STONE), NEPHROCALCINOSIS RENAL OR RENAL TUMOR, UTRETERIC STRICTURE (NARROW URETERS) UNDWELING CATHETER
RECURRENT UTI TMP/SMZ RELAPSE 20% OF RECOLONIZATION WITH PREVIOUS INFECTIOUS ORGANISM-ABNORMALITY UT TRACT, OR KIDNEY, PROSTITIS REINFECTON- 80%DIFFERENT INFECTIOUS PROCESS LOWER URINARY TRACT I,E INTERCOURSE
ACUTE BACTERIAL PROSTATITIS(E.COLI 80%) RESPOND WELL TO ANTIBIOTIC INFLAMMATION OF THE PROSTATE CAUSED BY OCAL BACTERIAL INFECTION CAUSED BY LOCAL BACTERIA INFECTION S/S HIGH FEVER, CHILLS, MALAISE, MYALGIA, BODYACHE, URGENCY, FEQUENCY URINARY RETENTION, NOCTURIA I.EINDWELLING CATHETER, PROSTATE CANCER REMOVAL,
UURINARY TRACT ANTISEPTICS METHENAMINE AND NITROFURANTOIN NITROFURNTOIN LOW=BACTERIOSTATIC HIGH=BACTERICIDAL LOW UTI, RECURRENT, PROPHYLASIS,
NITROFURANTOIN ADR GI EFFECT(ANOREXIA ANDNV, DIARRHEA) BIRTH DEFECTS HEPATOTOXICYTY PERIPHERAL NEUROPATHY-NEURON DEGENERATION AND DEMYELINIZATION=IRREVERSIBLE
Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A.A female patient with acute pyelonephritis B.A male patient with acute prostatitis C.A female patient with recurring acute urinary tract infections D.A male patient with acute cystitis
Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? B. PT with pyelonephritis with S/S of high fever, chills, and severe flank pain C.A PT w/ acute cystitis who complains of dysuria, frequency, and urgency D. PT w/acute bacterial prostatitis with a mild fever, chills, and nocturia
Which drug does the nurse identify as a urinary tract antiseptic? Ciprofloxacin B.Ceftriaxone C.Nitrofurantoin D.Ceftazidime
A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug, which statement will the nurse include? C.“Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin.” D.“You will most likely need to have an increase in the dose of warfarin while taking sulfadiazine.”
A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? Hypotension B.Bronchospasm C.Temperature of 35.5C D.Widespread skin lesions
A patient who sustained second- and third-degree burns has been prescribed mafenide. Which statement about mafenide does the nurse identify as true? Use of mafenide can cause alkalosis. B.Mafenide is painful upon application. C.A blue-green to gray discoloration of the skin occurs with mafenide therapy. D.Mafenide exerts its therapeutic effect by the release of free silver.
Created by: Seka_nurse
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