A nurse is caring for a client with a severe bacterial infection. The healthcare provider is considering starting either a bactericidal or bacteriostatic antibiotic. Which of the following factors is most important in determining the appropriate choice of antibiotic?
The cost of the antibiotics
The frequency of dosing
The patient's immune status
The route of administration
The Correct Answer is C
A. The cost of the antibiotics.: While cost is a practical consideration in treatment planning, it should never determine the initial selection between bactericidal and bacteriostatic drugs. The choice must first focus on clinical safety and efficacy before financial factors are reviewed.
B. The frequency of dosing.: Dosing frequency affects patient adherence but does not influence whether a bactericidal or bacteriostatic antibiotic is indicated. The pharmacodynamics and mechanism of action related to the patient’s condition are more critical in selecting the right agent.
C. The patient's immune status.: Immune status is the most important factor because bacteriostatic drugs inhibit bacterial growth, relying on the patient’s immune system to eliminate the remaining organisms. In immunocompromised clients, such as those with HIV or undergoing chemotherapy, bactericidal drugs are preferred to directly destroy the bacteria.
D. The route of administration.: The route influences drug absorption and speed of therapeutic action but not the mechanism of bacterial control. Once the antibiotic class is determined, the route is chosen based on infection severity and patient condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. A client who has been complaining of frequent stools.: This medication is often prescribed to manage mild to moderate diarrhea, so frequent stools alone are not a contraindication. Instead, it may help decrease stool frequency and improve consistency.
B. A client with an intestinal obstruction.: Bismuth subsalicylate should be avoided in clients with bowel obstruction because it can worsen abdominal distention and delay gastric emptying. It may mask symptoms of a more serious underlying condition, such as perforation or ischemia.
C. An adult who is dehydrated.: While dehydration should be corrected, bismuth subsalicylate itself is not contraindicated. It may be used safely once rehydration is initiated to manage diarrhea and prevent further fluid loss.
D. A child with diarrhea associated with the flu.: Bismuth subsalicylate contains salicylate, which poses a risk for Reye’s syndrome when given to children or adolescents recovering from viral infections like influenza or varicella. This condition can lead to acute encephalopathy and liver damage.
E. A client with an allergy to aspirin.: Since bismuth subsalicylate is chemically related to salicylates, it can trigger hypersensitivity reactions in individuals allergic to aspirin. Symptoms may include rash, bronchospasm, or anaphylaxis, making it contraindicated.
Correct Answer is ["23"]
Explanation
Identify the infusion rate in milliliters per hour (mL/hr) and the drop factor.
Infusion Rate: 90 mL/hr
Drop Factor: 15 gtts/mL
Calculate the infusion rate in drops per minute (gtt/min).
Rate (gtt/min) = (Infusion Rate (mL/hr) x Drop Factor (gtts/mL)) / 60 minutes/hour
= (90 mL/hr x 15 gtts/mL) / 60 min/hr
= 1350 / 60
= 22.5 gtt/min.
Round the answer to the nearest whole number.
= 23 gtt/min.
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