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pathophar exam finaL
ch.88-89
| Question | Answer |
|---|---|
| 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 35.5C 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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