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Adams ch34 no_tb(1)

  1. 1. Pharmacology for Nurses A Pathophysiologic Approach Third Edition CHAPTER 34 Drugs for Bacterial InfectionPharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  2. 2. Pathogens• Organisms that can cause disease• Must bypass the body’s defenses – Bacteria, viruses – Fungi; intracellular organisms – Multicellular animals Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  3. 3. Pathogens (continued)• Cause disease in two ways – Invasiveness: divide rapidly to overcome and cause direct damage – Toxins: very small amounts disrupt normal cell function Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  4. 4. Pathogenicity and Virulence• Pathogenicity: ability of organism to cause infection• Virulence: ability of a microbe to produce disease when present in minute numbers Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  5. 5. Methods of Describing Bacteria• Basic Shapes – Bacilli- rod shape – Cocci-spherical – Spirilla-spiral shape Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  6. 6. Methods of Describing Bacteria (continued)• Ability to use oxygen – Aerobic- with O2 – Anaerobic- without O2• Staining Characteristics – Gram positive – Gram negative Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  7. 7. Anti-infective Drugs• Known as antibacterial, antimicrobial, antibiotic• Classified by – Chemical structures (e.g., aminoglycoside, Fluoroquinolone) – Mechanism of action (e.g., cell-wall inhibitor, folic-acid inhibitor) – See Table 34.1, Bacterial Pathogens and Disorders Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  8. 8. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  9. 9. Action of Anti-infective Drugs• Affect target organism’s structure, metabolism, or life cycle• Goal is to eliminate pathogen – Bactericidal – kill bacteria – Bacteriostatic – slow growth of bacteria Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  10. 10. Figure 34.1 Mechanisms of action of antimicrobial drugs Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  11. 11. Acquired Resistance• Occurs when pathogen acquires gene for bacterial resistance – Through maturation  Antibiotics destroy sensitive bacteria  Insensitive (mutated) bacteria remain Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  12. 12. Acquired Resistance (continued) • Mutation random, occur during cell division • Mutated bacteria multiply • Antibiotics do not create mutations • By another microbe – Bacteria passed to others Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  13. 13. Widespread Use of antibiotics• Resistance not caused by but is worsened by overprescription of antibiotics – Results in loss of antibiotic effectiveness• Only prescribe when necessary• Long-time use increases resistant strains Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  14. 14. Widespread Use of antibiotics (continued)• Nosocomial infections often resistant• Prophylactic use sometimes appropriate• Nurse should instruct client to take full dose Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  15. 15. Figure 34.2 Acquired resistance Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  16. 16. Role of the Nurse• Monitor client’s condition• Provide client education• Obtain medical, surgical, and drug history• Assess lifestyle and dietary habits• Obtain description of symptomology and current therapies Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  17. 17. Role of the Nurse (continued)• Obtain specimens for culture and sensitivity prior to start of therapy• Monitor for indication of response to therapy – Reduced fever – Normal white blood count – Improved appetite – Absence of symptoms such as cough Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  18. 18. Role of the Nurse (continued)• After parenteral administration, observe closely for possible allergic reactions• Monitor for superinfections – Replace natural colon flora with probiotic supplements or cultured diary products Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  19. 19. Role of the Nurse (continued)• Teach clients to – Wear medic-alert bracelets if allergic to antibiotics – Report symptoms of allergic reaction – Not stop taking drug until complete prescription has been taken Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  20. 20. Drug Therapy with Penicillin• Assess previous drug reactions to penicillin• Avoid cephalosporins if client has history of severe penicillin allergy• Monitor for hyperkalemia and hypernatremia• Monitor cardiac status, including ECG changes Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  21. 21. PenicillinPharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  22. 22. PenicillinPharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  23. 23. Cephalosporin Therapy• Assess for presence or history of bleeding disorders – Cephalosporins may reduce prothrombin levels• Assess renal and hepatic function• Avoid alcohol – Some cephalosporins cause disulfiram (Antabuse)-like reaction with alcohol Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  24. 24. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  25. 25. Tetracycline Therapy• Contraindicated for clients who are pregnant or lactating – Effect on linear skeletal growth of fetus and child• Contraindicated in children less than 8 years of age – Permanent mottling and discoloration of teeth Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  26. 26. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  27. 27. Tetracycline Therapy (continued) • Tetracycline decrease effectiveness of oral contraceptives – Alternate birth-control method should be used while taking medication • Use caution in clients with impaired kidney or liver function Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  28. 28. Tetracycline Therapy (continued) • Photosensitivity may result • Do not take with milk products, iron supplements, magnesium-containing laxatives, or antacids Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  29. 29. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  30. 30. Macrolide Therapy• Assess presence of respiratory infection• Examine client for history of cardiac disorders• Monitor hepatic enzymes with certain macrolides, such as erythromycin estolate• Multiple-drug-drug interactions occur with macrolides Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  31. 31. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  32. 32. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  33. 33. Aminoglycoside Therapy• Monitor for ototoxicity and nephrotoxicity• Hearing loss may occur after therapy has been completed• Neuromuscular function may also be impaired• Increase fluid intake, unless otherwise contraindicated, to promote excretion Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  34. 34. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  35. 35. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  36. 36. Fluoroquinolone Therapy• Monitor white blood count• Monitor client with liver and renal dysfunction• Teach that drugs may cause dizziness and lightheadedness – Advise against driving or performing hazardous tasks during drug therapy Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  37. 37. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  38. 38. Fluoroquinolone Therapy (continued)• Norfloxacin (Noroxin) may cause photophobia• Teach that drug may affect tendons, especially in children Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  39. 39. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  40. 40. Sulfonamide Therapy• Assess for anemia or other hematological disorders• Assess renal function; sulfonamides may increase risk of crystalluria Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  41. 41. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  42. 42. Sulfonamide Therapy (continued) • Contraindicated in clients with history of hypersensitivity to sulfonamides – Can induce skin abnormality called Stevens- Johnson syndrome • Teach clients how to decrease effects of photosensitivity Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  43. 43. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  44. 44. Selection of an Antibiotic• Careful selection of correct antibiotic – essential – Use of culture and sensitivity testing – For effective pharmacotherapy; to limit adverse effects Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  45. 45. Selection of an Antibiotic (continued)• Broad spectrum antibiotics – Effective for a wide variety of bacteria• Narrow spectrum antibiotics – Effective for narrow group of bacteria Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  46. 46. Culture and Sensitivity Testing• Examination of specimen for microorganisms• Grown in Lab and identified• Tested for sensitivity to different antibiotics Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  47. 47. Culture and Sensitivity Testing (continued)• Bacteria may take several days to identify• Viruses may take several weeks to identify• Broad spectrum antibiotics may be started before lab culture completed Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  48. 48. Multidrug Therapy• Affected by antagonism-combining two drugs may decrease efficacy of each• Use of multiple antibiotics increases risk of resistance• Multidrug therapy can be used – When multi-organisms cause infection – For treatment of tuberculosis – For treatment of HIV Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  49. 49. Superinfections• Secondary infections that occur when too many host flora are killed by an antibiotic – Host flora prevent growth of pathogenic organisms Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  50. 50. Superinfections (continued)• Pathogenic microorganisms have chance to multiply – Opportunistic- take advantage of suppressed immune system – Signs and symptoms include diarrhea, bladder pain, painful urination, or abnormal vaginal discharge Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  51. 51. Host Factors Influence Choice of Antibiotics • Host Factors Influence Choice of Antibiotics • Immune system status • Local condition at infection site • Allergic reactions • Age • Pregnancy • Genetics Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  52. 52. Penicillin• Prototype drug: penicillin G (Pentids)• Mechanism of action: to kill bacteria by disrupting their cell walls• Primary use: as a drug of choice against streptococci, pneumococci, and staphylococci organisms that do not produce penicillinase – Also medication of choice for gonorrhea and syphilis Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  53. 53. Penicillin (continued)• Adverse effects: diarrhea, nausea, vomiting, superinfections, anaphylaxis Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  54. 54. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  55. 55. Cephalosporins• Prototype drug: cefotaxime (Claforan)• Mechanism of action: to act with broad spectrum activity against gram-negative organisms• Primary use: for serious infections of lower respiratory tract, central nervous system, genitourinary system, bones, blood and joints Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  56. 56. Cephalosporins (continued)• Adverse effects: hypersensitivity, anaphylaxis diarrhea, vomiting, nausea, pain at injection site Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  57. 57. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  58. 58. Tetracycline• Prototype drug: tetracycline HCL (Achromycin, others)• Mechanism of action: effective against broad range of gram-positive and gram- negative organisms• Primary use: clamydiae, rickettsiae, and mycoplasma Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  59. 59. Tetracycline (continued)• Adverse effects: superinfections, nausea, vomiting, diarrhea, discoloration of teeth, photosensitivity Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  60. 60. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  61. 61. Macrolide• Prototype drug: erythromycin (E-Mycin, Erythrocin)• Mechanism of action: to act as spectrum similar to that of penicillins – Also effective against gram-positive bacteria• Primary use: for Bordetella pertusis (whooping cough) and Corynebacterium diphtheriae, most gram-positive bacteria Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  62. 62. Macrolide (continued)• Adverse effects: nausea, abdominal cramping and vomiting, diarrhea – Most severe is hepatotoxicity Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  63. 63. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  64. 64. Aminoglycoside• Prototype drug: gentamycin (Garamycin)• Mechanism of action: to act as broad- spectrum, bacteriocidal antibiotic Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  65. 65. Macrolide• Primary use: for serious urinary, respiratory, nervous, or GI infections – Often used in combination with other antibiotics – Used parenterally or as drops (Genoptic) for eye infections• Adverse effects: ototoxiciy, and nephrotoxicity Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  66. 66. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  67. 67. Fluoroquinolone• Prototype drug: ciprofloxacin (Cipro)• Mechanism of action: to inhibit bacterial DNA gyrase – Affects bacterial replication and DNA repair• Primary use: for respiratory infections, bone and joint infections, GI infections, ophthalmic infections, sinusitis, and prostatitis Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  68. 68. Fluoroquinolone (continued)• Adverse effects: nausea, vomiting, diarrhea, phototoxicity, headache, dizziness Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  69. 69. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  70. 70. Sulfonamide• Prototype drug: trimethoprim- sulfamethoxazole (Bactrim, Septra)• Mechanism of action: to kill bacteria by inhibiting bacterial metabolism of folic acid• Primary use: for urinary tract infections, Pneumocystis carinii pneumonia, shigella infections of small bowel, and acute episodes of chronic bronchitis Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  71. 71. Sulfonamide (continued)• Adverse effects: skin rashes, nausea, vomiting, agranulocytosis or thrombocytopenia Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  72. 72. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc.Adams • Holland All rights reserved.
  73. 73. Miscellaneous• Clindamycin (Cleocin): for oral infections caused by bacteroides – Associated with pseudomembraneous colitis – Metronidazole (Flagyl) used to treat H. Pylori infections of stomach Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  74. 74. Miscellaneous (continued)• Vancomycin (Vancocin) effective for MRSA infections – Adverse effects: ototoxicity, nephrotoxicity, red man syndrome Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  75. 75. Miscellaneous - new• Oxazolidinones: linezolid (Zyvox) – as effective as vancomycin against MRSA• Cyclic lipopeptides: daptomycin (Cubicin)- used to treat serious skin infections• Carbapenems: imipenem (Primaxin) have some of the broadest spectrums Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  76. 76. Miscellaneous – new (continued) • Ketolides: telithromycin (Ketek) –used for respiratory infections • Glycylcyclines: tigecycline (Tygacil) used for drug-resistant abdominal infections and complicated skin infections Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  77. 77. Patients Receiving Antibacterial Therapy• Assessment – Obtain complete health history—allergies, drugs, drug interactions – Obtain specimens for culture and sensitivity before initiating therapy – Perform infection-focused physical examination—vital signs, WBC count, sedimentation rate Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  78. 78. Patients Receiving Antibacterial Therapy (continued)• Nursing diagnoses – Pain (related to infection) – Infection – Hyperthermia – Risk for Injury (related to adverse drug effects) – Deficient knowledge, related to drug therapy Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  79. 79. Patients Receiving Antibacterial Therapy (continued)• Nursing diagnoses – Risk for Deficient Fluid Volume (related to fever, diarrhea caused by adverse drug effects) – Risk for Noncompliance (related to adverse drug effects, deficient knowledge, or cost of medication) Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  80. 80. Patients Receiving Antibacterial Therapyn (continued)• Planning—patient will – Report diminished signs and symptoms of infection, decreased fever and fatigue, increased appetite) – Be free from, or experiences minimal adverse effects Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  81. 81. Patients Receiving Antibacterial Therapyn (continued)• Planning—patient will – Verbalize an understanding of the drug’s use, adverse effects and required precautions. – Demonstrate proper self-administration of the medication (e.g., dose, timing, when to notify provider) Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  82. 82. Patients Receiving Antibacterial Therapy (continued)• Implementation – Monitor vital signs and symptoms of infection – Monitor for hypersensitivity reaction – Monitor for severe diarrhea – Administer drug around the clock – Monitor for superinfection – Monitor intake of OTC products – Monitor for photosensitivity Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  83. 83. Patients Receiving Antibacterial Therapy (continued)• Implementation – Determine food and beverage interactions – Monitor IV site for signs of tissue irritation, severe pain, extravasation – Monitor for side effects, renal function, symptoms of ototoxicity, compliance with antibiotic therapy Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  84. 84. Patients Receiving Antibacterial Therapy (continued)• Evaluation—patient – Reports diminished signs and symptoms of infection, decreased fever – Is free from, or experiences minimal adverse effects. Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.
  85. 85. Patients Receiving Antibacterial Therapy (continued)• Evaluation—patient – Verbalizes an understanding of the drug’s use, adverse effects and required precautions. – Demonstrates proper self-administration of the medication (e.g., dose, timing, when to notify provider). Pharmacology for Nurses: A Pathophysiologic Approach, Third Edition Copyright ©2011 by Pearson Education, Inc. Adams • Holland All rights reserved.

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