Antibiotics P2

An ED patient with fever and hypotension is started on IV cefepime before cultures. This represents:

• Definitive therapy

• Empiric therapy

• Prophylaxis

• Subtherapeutic therapy

A hospitalized patient on day 4 develops new productive cough and fever. Best classification:

• Community-acquired pneumonia

• Nosocomial pneumonia

• Colonization

• Viral URI

A patient on warfarin begins TMP-SMX for UTI. Which lab is priority to monitor within 48–72 hours?

• Serum potassium

• INR

• TSH

• ALT/AST only

Which cephalosporin has MRSA coverage?

• Cefazolin

• Ceftriaxone

• Ceftaroline

• Cefepime

A 6-year-old with cystic fibrosis has Pseudomonas lung infection. Which statement about quinolones is most accurate?

• Absolutely contraindicated in all children

• May be used judiciously when benefits outweigh risks

• Only topical forms are allowed

• Safe without monitoring

Patient on imipenem/cilastatin becomes confused and has myoclonic jerks. History includes epilepsy. Priority action:

• Administer antiemetic

• Check dosing/renal function and notify provider

• Give antidiarrheal

• Reassure and continue

Patient on azithromycin complains of palpitations. Next best step:

• Stop drug and check ECG for QT prolongation

• Ignore if BP is normal

• Give calcium to offset effect

• Start beta-blocker immediately

Post-op patient receiving clindamycin develops profuse watery diarrhea. Initial nursing response:

• Administer loperamide

• Collect stool for C. difficile testing and notify provider

• Encourage dairy products

• Hold fluids to rest bowel

Gentamicin plus piperacillin is ordered for suspected enterococcal endocarditis. The rationale is:

• Antagonism to reduce toxicity

• Synergy to enhance bacterial killing

• Coverage duplication only

• Prevent QT prolongation

A patient with MRSA pneumonia is being considered for daptomycin. Best nursing statement:

• This is appropriate because daptomycin concentrates in the lungs

• Daptomycin is inactivated by surfactant and not used for pneumonia

• We must give it as an IV push

• Oral daptomycin is preferred