CHAPTER 9 ANTIBIOTICS

Saripada, Bassam G. BS Nursing 2B Pharmacology

1. An 80-year-old client who weighs 60 kg is admitted to the hospital with fever and confusion. She has
been taking a diuretic and is diagnosed with dehydration and UTI. The patient is prescribed gentamicin
180 mg IV to be given three times each day.

a. Which labs should be monitored before and during the antibiotic therapy?
ANSWER: Culture and sensitivity tests should be performed before administering gentamicin to ensure
that it is the right drug to use. Following along will be the renal and hepatic function tests. These test
should be performed before to determine the baseline function of these organs and during to see of dose
adjustments are necessary which helps reduce the risk of toxicity

b. Explain why gentamicin may be contraindicated in this patient.

ANSWER: Gentamicin may be contraindicated in this patient because she is dehydrated and has been
taking diuretics. If gentamicin is administered with these contraindications, it will increase the risk of
ototoxicity, nephrotoxicity, and neurotoxicity.

c. What special nursing considerations should be considered based on the patient’s age?
ANSWER: Base on the patient’s age, renal function should be especially monitored before and during the
antibiotic treatment. At her age, gentamicin levels can remain higher and for a longer period because of
the less effective excretion owing to less efficient kidneys.

Describe the acceptable dosage for this patient. How does the patient’s age affect dosing?

2. Linda C. is a 25-year-old patient who is being treated for sexually transmitted diseases with
sulfisoxazole (Gantrisin) and doxycycline (Doryx).

a. Explain the difference between sulfisoxazole (Gantrisin) and doxycycline (Doryx).

ANSWER: On the first hand Gantrisin acetyl sulfisoxazole pediatric suspension is a sulfonamide
antibiotic used to treat or prevent many different types of infections caused by bacteria, such as bladder
infections, ear infections, or meningitis. On the other hand Doxycycline is used to treat many different
bacterial infections, such as acne, urinary tract infections, intestinal infections, eye
infections, gonorrhea, chlamydia, periodontitis, gum disease, and others.

b. What medication instructions should be taught to this patient?

ANSWER: A single 1 g dose of azithromycin over a seven-day course of doxycycline which can be
administered as either 100 mg of doxycycline orally twice daily, or as a single daily dose of a formulation
of Doryx which can be administered as 200 mg orally once daily. Both doxycycline regimens should be
administered for seven days. And other teaching is using of condoms to provide the best protection
available, they should be used during any potential exposure to a sexually transmitted disease (STD).

3. You instruct Linda C. that she will need to use a barrier contraceptive method for birth control because
oral contraceptives may not be effective while a tetracycline is being used. She states that she would like
to become pregnant. What information should she be given?
ANSWER:

STDs don’t just appear from nothing they have to be passed from one person to another. So if
you’ve been using condoms and get tested regularly you can stay on top of the whole STD thing. But if
you do find out you have an STD. Most are easy to treat, so it’s just a matter of getting the right medicine
and waiting until both people have been retested before trying to get pregnant.
If one or both people find out they have an STD that can’t be cured, like HIV or herpes, there are special
options that can allow them to safely get pregnant and give birth. Genital herpes can be treated with
medicine that makes it less likely for someone to pass it on to their partner and to prevent complications
at birth. And people living with HIV who want to start a family have options to prevent passing it to their
children.