Razelle Joy C.

Rodriguez

BSN – 2NF

CASE STUDY 2: CLIENT WITH A PSEUDOMONAL INFECTION

1.) Amoxicillin and penicillin belong to the same class of medications. Amoxicillin
was created by chemically altering penicillins to increase its potency, whereas
the drugs penicillin V and penicillin G are naturally occurring penicillins.
Amoxicillin thus has a tendency to cure a wider variety of bacterial illnesses.

2.) The gravity infusion IV pump is the most suitable intravenous infusion method for
FSH. By clamping on the IV tubing to either speed up or slow down the IV fluid
flow, the medical professional is able to control the IV infusion rate. The flow rate
would be 33 gtts/minute if FSH were to be delivered with Amikacin sulfate in 100
mL of Dextrose 5% in Water over 45 minutes every 8 hours and the drop factor
was 15 gtts/mL.

3.) A bacterial wound culture test must be carried out, according to Labcorp (n.d.), in
order to identify the bacteria that caused the illness. The test will help doctors
determine whether the wound has become infected, what kind of bacteria caused
the infection, and which antibiotic would be most suited to treat the infection and
promote wound healing. As a result, a wound culture test is required to direct the
management of the infection in FSH.

4.) Antibiotics, including Amikacins, can save lives, but they can have certain
negative side effects. Antibiotics known as aminoglycosides have the potential to
have adverse effects such as hearing loss and balance issues (ototoxicity). Since
amikacin belongs to the aforementioned antibiotic family, it is crucial to test
FSH's hearing both before and after starting medication therapy.
The tests or evaluations listed below can be used to determine whether someone
has ototoxicity:
1. behavioral or audiometric hearing tests
2. Test of the auditory brainstem response (ABR)
3. Test for otoacoustic emissions (OAE)
4. Tympanometry
5. Electronystagmogram
6. Posturography
7. completing surveys about balance, wooziness, and other symptoms
8. additional tests, including the vestibular autorotation test,
 5.) The typical daily urine production must be between 800 and 2000 mL, or 267 to
667 mL when split by three (24 hours divided by 8 hours = 3). As a result, the
urine production of FSH, which has been 125 mL for the past eight hours, is
noticeably low. This is connected to his Amikacin treatment. Aminoglycosides are
known to be nephrotoxic, which indicates that one of its adverse effects may be
to harm the patient's kidneys. This may account for the last eight hours' reduced
urine production in FSH. The nurse must do the following interventions to help
the patient with this issue:
1. Let the doctor know how the patient is doing.
2. Encourage the patient to drink more liquids, particularly water.
3. The patient's fluid intake and outflow should be observed.
4. Analyze how the nursing interventions performed.
5. Implement the prescription if the doctor has provided one to deal with the
patient's problem.
6. Analyze the results of the doctor's prescription.

6.) To ascertain a person's current level of renal function, two quick tests can be
performed. ACR urine testing and GFR blood testing are these procedures. The
albumin to creatinine ratio, sometimes known as ACR, primarily considers
albumin levels in the urine. The blood must contain albumin, not the urine, for the
protein to exist. It is a sign that your kidneys are not properly filtering your blood if
this protein is detected in your urine. If so, this could indicate the beginning of
renal disease. In contrast, a blood test is used to determine GFR, or glomerular
filtration rate. A byproduct of the muscles, creatinine is a waste substance.
Kidney damage may make it more difficult to remove creatinine from the blood.
The first step is a creatinine test. Your glomerular filtration rate, which is
calculated using your creatinine result, will subsequently be used to estimate the
condition of your kidneys.

7.) The peak serum levels and the trough serum levels must be periodically checked
while giving a patient amikacin medication. According to Labcorp (n.d.), the peak
samples need to be taken 60 minutes after the IM injection, 30 minutes after the
end of a 30-minute IV infusion, or right away following a 60-minute IV infusion.
The trough sample has to be taken just before the next dosage is given.

SOURCES:

Healthline. (2016, September 23). Rinne and Webber Tests.

https://www.healthline.com/health/rinne-and-weber-tests
Kunde, R. (2022, April 27). What to Know About Ototoxicity. https://www.webmd.com/a-
to-z-guides/what-to-know-
aboutototoxicity#:~:text=Ototoxicity%20is%20a%20medical%20term,health%20issues%
20 can%20cause%20ototoxicity.

Labcorp. (n.d.). Bacterial Wound Culture. https://www.labcorp.com/help/patient-

testinfo/bacterial-wound-culture

Labcorp. (n.d.). Amikacin, Peak.

https://www.labcorp.com/tests/007204/amikacinpeak#:~:text=Both%20peak%20and%2
0trough%20concentrations,a%2060%2Dminu te%20IV%20infusion.

MedlinePlus. (2015, December 15). Amikacin Injection.

https://medlineplus.gov/druginfo/meds/a682661.html#:~:text=Amikacin%20injection
%20is%20in%20a,flu%2C%20or%20other%20viral%20infections.

MedlinePlus. (2021, July 19). Urine 24-hour volume.

https://medlineplus.gov/ency/article/003425.htm#:~:text=Normal%20Results&text=Th
e%20normal%20range%20for%2024,about%202%20liters%20per%20day).

National Kidney Foundation. (n.d.). Know Your Kidney Numbers: Two Simple Tests.
https://www.kidney.org/atoz/content/know-your-kidney-numbers-two-
simpletests#:~:text=Your%20kidney%20numbers%20include%202,performed%20throu
gh %20a%20blood%20test.

Sruthi, M. (2021, May 5). How Do Aminoglycosides Work?

https://www.rxlist.com/how_do_aminoglycosides_work/drug-class.htm

Victory, J. (2022, July 7). Some life-saving antibiotics may cause hearing loss and
balance problems. https://www.healthyhearing.com/report/52556-Can-antibioticscause-
hearing-loss

Terez Malka, M. D. (2022, January 24). Amoxicillin vs. penicillin: Similarities, differences
& prices. K Health. Retrieved August 30, 2022, from
https://khealth.com/learn/antibiotics/amoxicillin-vs-penicillin/