Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
7 Cards in this Set
- Front
- Back
|
The NP sees a three-year-old child who has a history of recurrent otitis media. The child's parent tells the NP that the child is allergic to penicillin. The NP learns that the child developed an all over rash two days after starting amoxicillin at Age 2 years. The NP should |
Order a penicillin skin test. Although it is true that patient report correlates poorly with actual allergy, there is a risk of life-threatening anaphylaxis with a true penicillin allergy. The NP should order a penicillin skin test to verify allergy. If the skin test is positive, the patient should avoid B lactam antimicrobials. Penicillin desensitization can be used for penicillin allergic patients who need penicillins |
|
|
A patient with group A hemolytic streptococcal pharyngitis is treated with Penicillin V. At a follow-up visit two weeks later, the patient presents with edema of the hands and feet, blood pressure of 140/ 85, and Coca-Cola colored urine. A urine dipstick shows proteinuria. The NP should |
Obtain an ASO titer and creatinine clearance. A minimum of 10 days of treatment is recommended for any infection caused by group a hemolytic streptococcus to prevent the occurrence of rheumatic fever or acute glomerulonephritis. This patient shows signs of acute glomerulonephritis, so the NP should obtain an ASO titer and creatinine clearance to help confirm the diagnosis. It is not necessary to repeat the throat culture. Treatment involves controlling blood pressure and maintaining Renal function, not giving antibiotics |
|
|
A patient is taking dicloxacillin, dynapen, 500 mg every 6 hours to treat a severe penicillinase resistant infection. At a one week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The NP should |
Order blood cultures, a WBC count with differential and liver function tests. When giving penicillinase resistant penicillins, it is important to monitor therapy with blood cultures, WBC with differential cell counts, and liver function tests before treatment and weekly during treatment. This patient may have typical gastrointestinal side effects, but the symptoms may also indicate hepatic damage. Changing the medication is not indicated, unless serious side effects are present. Decreasing the dose is not indicated |
|
|
The NP administers penicillin G, bicillin, to a 75 year old patient who has COPD and heart failure. The patient takes digoxin, Warfarin, and spironolactone. To help prevent drug interactions, the NP should order |
Serum electrolytes. Penicillin G can cause hyperkalemia, which can increase digoxin toxicity, so serum electrolytes should be monitored. Penicillin G does not interact with Warfarin or spironolactone. Coagulation studies, creatinine clearance, and lfts are not indicated in this circumstance |
|
|
Is sexually active woman is being treated for streptococcal pharyngitis. The patient takes oral contraceptive pills. Which penicillin should the NP prescribe for this patient |
Penicillin G. Although penicillin V is the drug of choice, ampicillin and penicillin G can be used to treat streptococcal pharyngitis. Penicillin G is the only penicillin that does not interfere with oral contraceptive pills. Dicloxacillin is not recommended to treat streptococcal pharyngitis |
|
|
A patient was seen in a local emergency department and was treated empirically for pharyngitis with ampicillin and comes to the clinic two days later with urticarial rash. The patient has no previous history of atopy and does not have respiratory symptoms. The NP should suspect |
Mononucleosis. A non allergic urticaria rash occasionally occurs with ampicillin and is common in patients with mononucleosis. This patient has pharyngitis, which was not diagnosed by throat culture. The NP should suspect mononucleosis and a non allergic rash. Serum sickness and penicillin allergy are possible but less likely. A scarlatiniform rash is not urticarial |
|
|
A patient with otitis media is treated for 10 days with Amoxicillin. At the follow-up visit the primary NP notes bilateral erythematous bulging tympanic membranes. The NP should prescribe |
Oral amoxicillin clavulanate, Augmentin, for 10 days. Antibiotic resistance to penicillin occurs through three mechanisms, the most common being bacteria producing beta lactamase, which breaks down the B lactam ring and renders the penicillin inactive. Clavulanate acid, used in combination with penicillins, prevents this inactivation. The NP should prescribe amoxicillin clavulanate. Giving 10 more days of amoxicillin would not be effective. Dicloxacillin is used when resistance is caused by penicillinase resistant staphylococcal infections. Penicillin G is not used to treat otitis media |
