Nursing Consideration/interventions

amoxicillin

GI Effects: Watch for bloody stools or prolonged diarrhea; may signal serious infection.

Superinfections: Monitor for oral/vaginal Candida; treat with antifungals.

Allergies:

• Ask about allergies before first dose.

• Watch for rash, hives, or anaphylaxis.

• Treat mild reactions with antihistamines; severe with epinephrine and respiratory support.

• Keep clients in facility for 30 minutes after IM/IV doses to monitor for allergic reactions

cephalexin

GI Monitoring: Report bloody stools or watery diarrhea.

Allergy Check: Assess for penicillin/cephalosporin allergy before giving.

Allergic Reactions: Treat rash/hives with antihistamines; anaphylaxis with epinephrine and airway support.

Bleeding Risk: Monitor PT/bleeding time; give vitamin K if bleeding occurs.

IV Care: Watch for thrombophlebitis; infuse slowly and per guidelines.

Vancomycin

Infuse IV over 1 hour; follow proper dilution guidelines.

Monitor vital signs during infusion.

Check vancomycin trough levels, BUN, and creatinine to assess kidney function.

Assess IV site for redness, swelling, and patency throughout infusion.

Tetracycline

Give with non-dairy foods if GI upset occurs.

Monitor and report GI symptoms (dose may need adjustment).

Check for pregnancy in clients of childbearing age before administering.

Monitor liver function tests and watch for signs of liver damage.

Monitor for superinfection, skin reactions, lymphadenopathy, and facial swelling.

nitrofurantoin

Monitor and report:

• GI symptoms (may need dose/form change)

• Respiratory issues (may require discontinuation)

• Neuropathy signs

• Blood component labs

Administration:

• Do not crush capsules

• Dilute suspension in milk or juice

• Have client rinse mouth after suspension

Track intake/output and bowel function

trimethoprim/sulfamethoxazole

Monitor and report:

• Severe symptoms, rash, hives, blisters, and severe diarrhea

Encourage fluid intake

Track intake/output (I&O)

Monitor CBC and urinalysis during treatment

Ciprofloxicin

Monitor and report GI symptoms (dose adjustment may be necessary).

Monitor for tendon pain; discontinue medication if pain occurs.

Advise clients to avoid sun exposure by wearing protective clothing and applying sunscreen.

gentamicin

Monitor and report tinnitus and other signs of early ototoxicity.

Monitor peak and trough blood levels of the medication.

Check BUN, creatinine, and urine for protein and casts; report any elevations.

Evaluate eighth cranial nerve function with audiometry tests.

Monitor intake and output (I&O) closely.

erythromycin

Monitor and report GI reactions; dose reduction may be needed.

Watch for drug interactions that increase erythromycin levels.

Assess for history of prolonged QT syndrome before administration.

Monitor for signs of ototoxicity and superinfection.

Monitor liver function tests with long-term use.

imipenem

Infuse IV at the recommended rate.

Monitor for nausea during infusion; treat with antiemetics as needed.

Check IV site for redness and swelling.

Assess and report any antibiotic allergy before starting imipenem.

Monitor for secondary infections like oral candidiasis.

Perform lab tests: AST, BUN, LDH, bilirubin, and creatinine levels.

azetreonam

Monitor site for redness, swelling, or pain.

Change IV sites if inflammation occurs.

Monitor for anaphylaxis.

Assess bowel function.

Acyclovir

Monitor and report severe skin reactions and other severe symptoms.

Monitor BUN and creatinine levels to assess kidney function.

Infuse IV medication slowly; ensure hydration during and for 2 hours after infusion to maintain urine output.

Monitor for central nervous system (CNS) effects.

Carefully observe the IV site during infusion.

ketoconazole

Monitor and report changes in liver function tests during treatment.

Monitor for and report severe GI manifestations.

Monitor for and report CNS effects.

amphotericin B

Administer diphenhydramine and acetaminophen before infusion to reduce reactions.

Monitor vital signs and observe for any adverse findings during infusion.

Check BUN, creatinine, and blood potassium regularly; report abnormalities.

Monitor weight and intake/output; notify provider for low output or significant weight changes.

Monitor hematocrit and CBC; report decreases.

Stop infusion immediately if respiratory distress occurs.

Chloroquine

•Monitor for and report any visual manifestations.

Monitor for and report severe GI manifestations.

Metronidazole

Monitor for and report severe GI manifestations.

Monitor for and report CNS manifestations; medication will be discontinued for seizure or neuropathy.

Rifampin

Monitor for flushing, rash, and itching.

Check liver enzyme levels regularly and report signs of hepatitis.

Be aware that soft contact lenses may stain from tears—inform client accordingly.

Monitor and report persistent GI symptoms.

Watch for signs of DRESS syndrome (fever, rash, lymphadenopathy, facial swelling, plus organ involvement); discontinue therapy immediately if symptoms appear

Isoniazid

Monitor and report GI symptoms.

Support and encourage medication adherence.

Regularly check liver enzyme levels and watch for liver damage.

Administer pyridoxine (vitamin B6) as prescribed to prevent/treat neuropathy.

Monitor for central nervous system (CNS) symptoms.

Watch for signs of DRESS syndrome (fever, rash, lymphadenopathy, facial swelling, and organ involvement); report promptly.