37 year old patient admitted for exploratory colonoscopy.

Surgical note

Patient is a 37 year old male with no past medical history taken today for exploratory colonoscopy with possible surgical intervention. Prior to surgery patient reported lower abdominal pain 8 out of 10, no blood or mucus in stool. Blood cultures were taken and resulted negative. Colonoscopy performed and shows normal tissue surrounding in descending colon. Diverticular abscess in sigmoid colon noted. Incision and drainage performed and samples obtained for colonic tissue culture. Patient to be started on antibiotics for abscess, pending culture results.

A nurse is caring for the patient post colonoscopy. The nurse reviews the medication administration record and notes a one time dose of cefazolin was given prior to the procedure. The healthcare provider then places a new order for ampicillin/sulbactam. Complete the following sentence by using the list of options.

The nurse understands that the antibiotic given prior to surgery is considered

___

therapy. Meanwhile the new antibiotic is used as

___

therapy.

i) Neurotoxicity: Neomycin, an aminoglycoside antibiotic, can lead to neurotoxicity, manifesting as muscle weakness or respiratory paralysis due to its effects on neuromuscular transmission. This risk is especially significant in vulnerable populations like infants or clients with impaired renal function.

ii) Nephrotoxicity: Neomycin is known for its potential to cause kidney damage due to its accumulation in renal tubular cells, leading to acute tubular necrosis. Monitoring renal function is critical when administering this medication, particularly in young children who are more susceptible to such effects.

Incorrect:

Hepatotoxicity: Neomycin is not associated with liver toxicity, as it primarily affects the kidneys and nervous system.

Cardiotoxicity: This is not a recognized adverse effect of neomycin.

Dermatotoxicity: While aminoglycosides may cause mild skin irritation, serious dermatotoxicity is not typical for neomycin.

Ototoxicity: Though highly relevant to other aminoglycosides, ototoxicity is less pronounced with neomycin because it is minimally absorbed systemically when used topically or orally.

Hemotoxicity: Neomycin is not known to directly affect blood components.

A) zidovudine (Retrovir):
Zidovudine is an antiretroviral medication used primarily to treat HIV infections by inhibiting the replication of the HIV virus. It is not effective for treating parasitic infections such as pinworms. Therefore, zidovudine is not an appropriate medication for treating pinworm infestations, which require anthelmintic therapy.

B) ketoconazole (Nizoral):
Ketoconazole is an antifungal medication used to treat fungal infections, such as those caused by dermatophytes or yeast. While it is effective against fungal pathogens, it does not have activity against parasitic infections like pinworms. It would not be used to treat an intestinal worm infection such as the one caused by pinworms (Enterobius vermicularis).

C) metronidazole (Flagyl):
Metronidazole is an antibiotic and antiprotozoal medication commonly used to treat infections caused by anaerobic bacteria and protozoa, such as Giardia lamblia or Trichomonas vaginalis. However, it is not effective against the nematode infection caused by pinworms. Although metronidazole is used for some parasitic infections, it is not the drug of choice for treating pinworm infestations.

D) mebendazole (Vermox):
Mebendazole is an anthelmintic (anti-worm) medication specifically used to treat infections caused by intestinal worms, including pinworms (Enterobius vermicularis). Mebendazole works by inhibiting the ability of the worm to absorb glucose, thereby starving and killing the parasite. It is one of the first-line treatments for pinworm infections and is commonly prescribed in cases of intense itching, particularly at night, which is a hallmark symptom of pinworm infestations.