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Infection Study Guide

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letutufwa's version from 2017-02-06 16:19

Section

Question Answer
What is colonization?The presence and growth of microbes
What puts someone at risk for infection?Breaks in the skin, impaired blood supply, neutropenia, malnutrition, poor hygiene
How are bacteria classified by shape?Cocci, bacilli, and spirilla
What are used to treat bacterial infections?Antibiotics
What are the symptoms of acute viral infections?Fever, headache, cough, malaise, muscle pain, insomnia, and photophobia
What does the white blood count look like during a viral infection?WBC remains normal
What is an antimicrobial?Any agent that harms a microbe
What is an antibiotic?Any substance produced by microbe that may harm another microbe
How are antimicrobials classified?Spectrum and mechanism of action
What are the spectrums?Narrow spectrum and broad spectrum
How does a bactericidal work?Kills the pathogen
How does a bacteriostatic work?Decreases or inhibits bacterial reproduction so patient can overcome infection
Important facts for antibioticsDon’t use antibiotics for viral infections; Only use when there is significant evidence of a bacterial infection; Use narrow-spectrum versus broad spectrum; Collect specimens for culture and stain before the first dose of the antibiotic is given; Don’t give antimicrobial therapy for a fever unless there is significant evidence of a bacterial infection
What is empiric therapy?Drug therapy that is initiated before obtaining a definite diagnosis
What does a culture determine?The causative pathogen
What does a sensitivity test determine?The susceptibility of the organism to an antibiotic
What does MIC stand for?Minimum inhibitory concentration
What are gram-negative pathogens’ O2 requirement?Anaerobic
When is the peak level drawn?1 hour after IV, IM administration
When is the trough level drawn?Prior to the next dose of medication
What are superinfections related to?Decrease in normal flora that competes with harmful organisms
What does candida cause?Yeast infection
What does pseudomembranous colitis cause?Clostridium difficile (profuse, watery diarrhea)
How would you monitor renal function?BUN, Creatinine, INR
How would you monitor hepatic function?Liver enzymes
How would you monitor bone marrow function?CBC
What is Probenecid used for?Increases concentration and extends action of penicillins
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β-lactam Antibacterial Agents

Question Answer
How do β-lactam antibacterial agents work?Inhibit cell wall synthesis
What is the prototype for penicillin?Ampicillin
What is its use?Broad spectrum
What are the adverse effects?GI symptoms, neuropathy, hypersensitivity
What is the black box warning?IV admin of Pen G
What is a nursing implication of penicillin?Exacerbates methotrexate
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Cephalosporin

Question Answer
What is the prototype?Cefazolin
What is it used for?Surgical prophylaxis
What is an adverse effect?Superinfections
What is a nursing implication of cephalosporin?Decrease prothrombin activity
How many generations of cephalosporins are there?5
1st gen cephalosporinmore active against gram positive
2nd gen cephalosporinmore active against gram negative (Treat resistant infection, prophylaxis for GYN surgeries)
3rd gen cephalosporinmore active against gram negative (Can penetrate inflamed meninges)
4th gen cephalosporingreater spectrum of antimicrobial activity, greater stability
5th gen cephalosporincommunity acquired infections (pneumonia and skin)
How long before the first surgical incision of surgery should this be given?60 minutes
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Carbapenems

Question Answer
What is the prototype?Imipenem-cilastatin
What is its use?Broad spectrum
What is an adverse effect?CNS toxicity
What are the nursing implications?Decrease concentration of divalproex, positive Croombs
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Aminoglycosides

Question Answer
How do aminoglycosides work?Penetrates the cell wall and prevents protein synthesis
What is the prototype?Gentamicin
What is are they used for?Empiric therapy
What are the adverse effects/black box warning?Nephrotoxicity and ototoxicity
memorize

Fluoroquinolones

Question Answer
How do fluoroquinolones work?Bactericidal
What is the prototype?Ciprofloxacin
What are they used for?Gram-negative bacteria
What is an adverse effect?Photosensitivity
What is a black box warning?Tendinitis and tendon rupture
What is contraindicated?Younger than age 18, tizanidine
What are the nursing implications?Prolong QT interval, chelate with cations, severe hypoglycemia
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Tetracyclines

Question Answer
How do tetracyclines work?Inhibits microbial protein synthesis
What is the prototype?Tetracycline hydrochloride
What are they used for?Mycoplasma, Chlamydia, Rickettsia, Lyme Disease
What are the adverse effects?CNS, superinfections
What are they contraindicated in?Renal failure, younger than age 8, and pregnancy
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Sulfonamides

Question Answer
How do sulfonamides work?Bacteriostatic
What is the prototype?Sulfisoxazole
What is it used for? UTI
Adverse effects hematological, dermatological, and urinary effects
Contraindications porphyria, G6PD deficiency, kidney and liver disease
Nursing implication pH of urine
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Macrolides

Question Answer
What is the prototype?erythromycin
How does it work? penicillin substitute
Adverse Effects hepatotoxicity, pseudomembranous colitis, CNS, ventricular dys
Contraindications / black box warning erythromycin estolate in liver disease
Nursing implication CYP3A4 liver enzymes
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Urinary Antiseptics

Question Answer
Anti-infective prototypesnitrofurantoin and trimethoprim
Analgesic prototype phenazopyridine hydrochloride
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Chloramphenicol

Question Answer
How does it work?bacteriostatic
How is it used? broad specturm
What is the black box warning? fatal dyscrasias; gray baby syndrome
What needs to be monitored for?Irreversible bone marrow depression
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Miscellaneous Antibiotics

Question Answer
ClindamycinSimilar to the macrolides in action and use
Clindamycin black box warning?fatal colitis
Linezolid: prototype?Oxazolidinone class
Linezolid: black box warning serotonin syndrome
Metronidazole treatsBacteria and protozoa
What happens when metronidazole is taken with alcohol? disulfiram reaction (flushing of the skin, accelerated heart rate, shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural syncope, and circulatory collapse)
Vancomycin is given for what and how?PO for C Diff
Vancomycin: Adverse effects ototoxicity, nephrotoxicity, red man syndrome
Vancomycin: Nursing implications give over an hour
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Anti-TB Meds

Question Answer
PT Isoniazid
Action bactericidal
Use alone or in combination
AE hepatotoxicity and peripheral neuropathy
BBW severe / fatal hepatitis can occur
CI liver disease, alcoholism, renal impairment
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Anti-TB / Rifamycins

Question Answer
Prototype Rifampin
Actionbactericidal
Usealone or in combo
AE harmless red/orange discoloration body fluids; superinfection
CI liver disease, alcoholism, and HIV treatment
NI induces P450 enzymes, Pt and INR
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Herpes Simplex Antiviral Medication

Question Answer
Prototype Acyclovir
Action interrupts DNA replication
Use HSV1 (lips) and HSV2 ( genital)
AE encephalopathy
CI heart failure, renal disease, and lactation
NI increased serum concentration of probenecid
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Influenza A Medication

Question Answer
Prototype oseltamivir phosphate
Action prevents new viral infection
Useflu A or B
AE conjunctivitis and nose bleed
CI breastfeeding
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Antifungal Medications - Polyenes

Question Answer
PrototypeAmphotericin B
Action -static or -cidal
Use Progressive and fatal infections
AE GU and hematological
CIRenal impairment
BBWHigh risk of toxicity
NI Test dose
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Antifungal Medications - Azoles

Question Answer
Prototypefluconazole
Action -static or -cidal
Use Systemic or topical fungal infections
AE Liver enzymes and hepatic necrosis
CI Pregnancy and lactation
NI Possible toxicity, inhibits some drugs
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Antimalarial Medications

Question Answer
PrototypeChloroquine phosphate
AE CNS, CV, ototoxicity and muscle weakness
CI retinal and visual field changes; pregnancy, lactation
NI take at the same time every day
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Antithelmintics

Question Answer
Prototype Mebendazole
AE GU, elevated liver enzymes
CI embryotoxic and teratogenic
NI stool sample three weeks after drug administration
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