FOCUS QUESTIONS FOR MODULE 2 EXAM

1. Which of the following describe the action of beta lactamase?

a. Beta-lactamases are enzymes that cleave the beta-lactam ring and thereby render penicillins

and other beta-lactam antibiotics inactive. Bacteria produce a large variety of beta-lactamases;

some are specific for penicillins, some are specific for other beta-lactam antibiotics, and some

act on several kinds of beta-lactam antibiotics. pg. 1030

b. They are enzymesthat cleave the beta-lactam ring and thereby render penicillin’s and other

beta-lactam antibiotics INACTIVE. Bacteria produce a large number of beta-lactamases.

2. The nurse is preparing to administer gentamicin (Garamycin) to a patient when he suddenly

complains of difficulty hearing. What should the nurse do?

a. If ototoxicity is detected, aminoglycosidesshould not administered and contact physician

b. The nurse should NOT administer the drug. It could cause irreversible impairment of hearing -

notify the physician

3. One of the most important factorsto consider in selection of appropriate antibiotic therapy is?

a. 3 principle factorsto produce maximal antimicrobial effects minimal harm

i. Identity of infecting organism

ii. Drug sensitivity of the infecting organism

iii. Host factors, such asthe site of infection and the status of host defenses (pg. 1019)

b. The therapeutic object is to produce maximal antimicrobial effects while causing minimal harm

to the host pg.1007 -Effective microbial therapy requires that we determine both the identity

and the drug sensitivity of drug of the infecting organism pg.1014

4. An objective symptom of infection is the presence of what?

a. Fever

i. Heat, inflammation ,tender loss of function bld work vitals While developing a fever is

the most

5. When administering the first dose of cefazolin to a patient, the nurse will monitor the patient closely

for a cross-sensitivity reaction if he has an allergy to what? Because your patient is on

aminoglycoside therapy, you as the nurse will assess the patient daily for the presence of what?

a. Cefazolin is a first generation cephalosporin. If, during the course of treatment, a nurse observes

signs of allergy appear (e.g., urticaria, rash, hypotension, difficulty in breathing), the

cephalosporin should be discontinued immediately. Patients with a history of cephalosporin

allergy should not be given these drugs. Because of structural similarities between penicillins

and cephalosporins, a few patients allergic to one type of drug may experience cross-reactivity

with the other. For patients with mild penicillin allergy, cephalosporins can be used with

minimal concern. However, because of the potential for fatal anaphylaxis, cephalosporins

should not be given to patients with a history of severe reactions to penicillins. (1040)

b. The aminoglycosides can produce serious toxicity, especially to the inner ears and kidneys

putting the patient at risk for ototoxicity. The inner ears and kidneys are vulnerable because

aminoglycosides become concentrated within cells of these structures. All aminoglycosides can

accumulate within the inner ears, causing cellular injury that can impair both hearing and

balance. Hearing impairment is caused by damage to sensory hair cells in the cochlea.

Disruption of balance is caused by damage to sensory hair cells of the vestibular apparatus. The

risk of nephrotoxicity is especially high in patients receiving other nephrotoxic drugs like the