NCLEX Review: Penicillins, Beta-Lactams, and Cephalosporins

A comprehensive set of practice flashcards covering the pathophysiology, mechanisms, classifications, nursing considerations, and NCLEX alerts for penicillins, beta-lactams, and cephalosporins based on Chapter 26 lecture notes.

What is the standard reproduction time for most bacteria?

Approximately every $20$ minutes.

What is the primary mechanism of action for penicillins and cephalosporins?

They interfere with bacterial cell wall synthesis, leading to cell lysis and death.

What specific structural component do penicillins contain that can be destroyed by bacterial enzymes?

A beta-lactam ring.

What percentage of cross-sensitivity exists between penicillins and cephalosporins?

Approximately 10\text{%}.

How are Gram-positive bacteria identified during staining?

They retain a purple stain (e.g., Staphylococcus aureus).

What is the physical appearance of staphylococci bacteria?

Cocci arranged in clusters.

What is the physical appearance of streptococci bacteria?

Cocci arranged in chains or strings.

Which drug class is famously known for inhibiting bacterial RNA/DNA synthesis?

Fluoroquinolones.

What is the difference between bactericidal and bacteriostatic antibiotics?

Bactericidal drugs kill bacteria directly, while bacteriostatic drugs stop their growth.

What is 'inherent resistance' in microbiology?

Natural resistance to an antibiotic without previous exposure, such as Pseudomonas aeruginosa's resistance to Penicillin G.

What describes 'acquired resistance'?

Bacteria becoming resistant after prior exposure to an antibiotic, such as Staphylococcus aureus becoming resistant to Penicillin G.

What are the priority nursing actions if a patient experiences anaphylaxis after a penicillin dose?

$1$. Stop the medication; $2$. Maintain the airway; $3$. Notify the provider; $4$. Administer epinephrine as ordered.

What is the definition of a superinfection?

A secondary infection that occurs when normal flora are destroyed by antibiotics (e.g., oral thrush or C. difficile).

Which toxicities are commonly associated with aminoglycosides?

Nephrotoxicity (kidney damage) and ototoxicity (hearing loss/balance issues).

Which specific penicillin group is used to treat Pseudomonas infections?

Extended-spectrum penicillins, such as Piperacillin-tazobactam.

What is the pharmacologic role of clavulanic acid when combined with amoxicillin?

It is a beta-lactamase inhibitor that protects amoxicillin from being destroyed by bacterial enzymes.

What is the approximate half-life of Amoxicillin?

$1 \text{--} 1.5$ hours.

Which patient education is vital regarding antibiotics and oral contraceptives?

Aminopenicillins like Ampicillin and Amoxicillin may decrease the effectiveness of oral contraceptives.

Why is imipenem combined with cilastatin?

To prevent the breakdown of the drug by the kidneys.

Which cephalosporin generation is effective against MRSA?

Fifth generation (e.g., Ceftaroline).

What is the peak time for IV Ceftriaxone?

$30$ minutes.

What must a nurse obtain before administering the first dose of a prescribed antibiotic?

Culture and sensitivity (C&S) samples.

Why are tetracyclines contraindicated during pregnancy?

They can cause fetal tooth discoloration and suppress bone growth.

What reaction should the nurse monitor for when administering IV Vancomycin rapidly?

Red man syndrome, characterized by flushing and hypotension.

What patient teaching is required for Metronidazole regarding alcohol consumption?

Avoid alcohol during therapy and for at least $48$ hours after the last dose to prevent a disulfiram-like reaction.

What is the risk of taking Linezolid concurrently with SSRIs?

Serotonin syndrome.

What adverse effect is a 'Black Box' warning for Fluoroquinolones like Ciprofloxacin?

Tendon rupture.

Which laboratory values are priority monitors for patients receiving aminoglycosides?

Creatinine and BUN to assess for nephrotoxicity.

Which antibiotic is considered safe and often preferred during pregnancy?

Penicillins (e.g., Amoxicillin) and Cephalosporins.

How long should a patient take their prescribed antibiotics?

They must finish the entire course, even if they feel better, to prevent antibiotic resistance.