Pharmacology infection
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| What are lines of defense against infection? | Individual immunity - heredity
Nutrition
Anatomical - good barriers (skin, mucus membranes, cilia)
Biochemical - acidic environment (stomach)
Mechanical - coughing, sneezing
Immune system status
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| What types of WBCs are there? | Neutrophils - first responders
Eosinophils - allergies
Basophils - healing
Lymphocytes - late (weeks)
Monocytes - chronic (months)
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| What are local signs of an inflammatory reaction? | Redness, swelling, warmth, pain
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| What are systemic signs of inflammation? | Leukocytes - high WBC count
General malaise and fatigue
Fever
Confusion in older adult
Enlarged lymph nodes
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| What are some causes of nosocomial infections? | Invasive procedures
Antibiotic administration
Exposure to multi-drug resistant organisms
Failure to follow standard precautions
Heredity
Nutritional deficiencies
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| What are some nursing interventions for infection? | Monitor temperature, vital signs, color, WBC count, LOC, energy level
Actions - wash hands, standard precautions, surgical asepsis, immunizations
Teaching - immunizations/infection
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| What needs to be considered in selection of antibiotics? | Identify organism (C & S)
Drug sensitivity of organism - MIC
Host factors - look at patient; don't use a med that is excreted by kidney on someone with kidney issues
Allergy
Penetration to site of infection
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| What are nursing implications of antibiotic therapy? | Baseline assessment
Monitoring therapy
Nursing actions
Patient education - take on empty stomach
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| What are properties of "cillins?" | Bacteriocidal
Weaken the cell wall
Prone to bacterial resistance
Some are narrow spectrum, some are broad spectrum
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| What are some "cillin" nursing interventions? | Monitor for allergic reactions
Take on empty stomach
Avoid foods that have a lot of acid
Complete course of antibiotics
Can give to people with meningitis - crosses BBB
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| What are the types of penicillin allergies? | Immediate (2-30 minutes)
Accelerated (1-72 hours)
Late (days or weeks)
Interventions - stop the treatment, provide respiratory support, give antihistamine (Benadryl)
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| What are some properties of cephalosporins? | Penicillin's cousin
Bactericidal
Beta-lactam antibiotic
Grouped in 4 generations
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| What are ADRs of cephalosporins? | Allergy similar to penicillins
Bleeding
Thrombophlebitis
Most are given IV because they don't absorb well from stomach
Do not give IM - painful
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| What are properties of aminoglycosides? | Narrow spectrum antibiotic
Bactericidal - disrupt protein synthesis
Used against aerobic gram-negative bacilli (E. coli and Pseudomonas)
Tobramycin and Gentamycin
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| What are ADRs of aminoglycosides? | Nephrotoxicity
Ototoxicity
Not absorbed well via GI tract, so given IV
Very narrow spectrum - need to do peaks and troughs
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| What are properties of sulfonamides and trimethoprim (Bactrim)? | Given for UTIs, CA-MRSA
Broad spectrum antibiotic
Bacteriostatic
Inhibits folic acid
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| What are ADRs of sulfonamides and trimethoprim? | Hypersensitivity - photosensitive
Blood dyscrasias - bleeding disorders
Rash
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| What are properties of tetracyclines? | Broad spectrum
Bacteriostatic
Take on empty stomach
Cannot take with milk; will bind with Ca2+, Fe3+, Mg2+, Al3+, Zn2+, and not be absorbed at all
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| What are ADRs of tetracyclines? | Photosensitivity
Stain teeth (yellow or brown)
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| What are properties of Macrolides? | Type of tetracycline
Erythromycin
Viaxin
Z-pack
Broad spectrum
Bacteriostatic
Use if allergic to penicillin
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| What are ADRs of erythromycin? | GI - causes nausea and vomiting
Do not use if you have a liver problem
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