Drug Therapies for Infectious Disease Case Studies

Description

After completing the following case study, submit 2 NCLEX style questions related to the topics covered in the case study. (Students are expected to write their own questions. Refrain from using outside resources). Please provide a rationale for the correct answers to your questions.

Antibiotics:

1. What is a culture and sensitivity test? When is this drawn and why?

Vancomycin:

A patient is prescribed vancomycin for a gram-positive organism. The nurse on the shift before you stated in the report that they could not find an IV pump, so they just hung the vancomycin and let it run to gravity. When you assess your patient, you notice flushing of the skin, a rash starting to appear, and the patient is becoming hypotensive.

1. What do you suspect is happening with this patient?
2. What is the cause of this rash? What could have been done to prevent this adverse effect for this patient?

Trough and Peak:

While you are preparing to start your shift as a nurse you review the laboratory studies that are needed for your patient. You notice that a trough level is ordered for your patient.

1. What is the purpose of this lab value with respect to antibiotic therapy?
2. When is the best time for you to draw this level?

Case Study 1:

Mr. Collins is a 52-year-old client with a history of chronic renal insufficiency who presents to the medical clinic complaining of a severe sore throat. He is diagnosed with streptococcal pharyngitis. He is informed by the primary care provider that he will be treated with ampicillin 500 mg every 6 hours.

1. What assessment data did the healthcare prescriber obtain before ordering the ampicillin?
2. What questions should the nurse ask Mr. Collins before the administration of the ampicillin?
3. What should the nurse include in the teaching plan for Mr. Collins before discharge?
4. Collins returns to his prescriber and does not seem to have improved.  He is given a prescription for ciprofloxacin 250 mg orally twice a day.  What additional patient teaching should the nurse provide?

Case Study 2:

Mr. Robert is a 45-year-old homeless man who comes to the emergency department and is diagnosed with tuberculosis.

1. What are the common symptoms of tuberculosis? What diagnostic tests are done to confirm this disease?
2. What are the four phases in the transmission and progression of TB and what are the healthcare concerns for patients and the public?
3. The TB infection is to be treated with a combination of isoniazid and rifampin. What should the nurse include in a teaching plan when discussing these medications with the patient?
4. Discuss strategies that will increase Mr. Robert’s compliance with drug therapy when he is discharged.