Which client should be most closely monitored for adverse effects ...

[bcretired]

Which client should be most closely monitored for adverse effects directly related to receiving penicillin G?
 
  1. A client who has osteomyelitis and will need IV medication for several months
  2. A client who had a myocardial infarction 2 days ago and now has a fever of 102F
  3. A client who is postop from corneal transplant
  4. A client who has diabetes and is on dialysis

Question 2

The nurse anticipates use of an extended-spectrum penicillins such as piperacillin when the patient is infected with which microbe?
 
  1. Streptococcus
  2. Herpes simplex
  3. Pseudomonas
  4. Staphylococcus

[Awesome]

Answer to Question 1

Correct Answer: 4
Rationale 1: Clients with osteomyelitis may receive several broad-spectrum antibiotics.
Rationale 2: This patient would be monitored for development of heart failure which is a contraindication to penicillin G, but this is not the correct answer as there is no indication that heart failure exists.
Rationale 3: Corneal transplant is not an indication for caution with penicillin.
Rationale 4: Clients with significant renal impairment must be monitored closely while on penicillin.
Global Rationale: Because 90 of a dose of penicillin G is excreted unchanged by the kidneys through tubular secretion, patients with significant renal impairment must be carefully monitored. Patients with heart failure should not receive the penicillin sodium salt. Hyperkalemia may result with high doses of the penicillin G potassium salt.

Answer to Question 2

Correct Answer: 3
Rationale 1: Extended-spectrum penicillins are effective against strep, but this is not their advantage.
Rationale 2: Extended-spectrum penicillins are not effective against herpes, a virus.
Rationale 3: Extended-spectrum penicillins have as their advantage antimicrobial activity against Pseudomonas.
Rationale 4: Extended-spectrum penicillins are effective against staph, but this is not their advantage.
Global Rationale: Piperacillin and ticarcillin have broad spectrums of antimicrobial activity similar to those of the aminopenicillins. Their primary advantage is their additional activity against Pseudomonas aeruginosa; thus they are called extended-spectrum or antipseudomonal penicillins.

[bcretired]

Excellent

[amandalm]

Gracias!