Hi guys, it's me, Professor D, and welcome back to my YouTube channel. On this video, we're doing another Kahoot, and we're going to be covering anti-infective agents. We're going to be going over things like antibiotics, antivirals, antifungal agents, okay? Before we get started, as always, I'm going to ask you to please support me and support this channel by liking this video. You're going to love it, so go ahead and give a thumbs up now so you don't forget.
Subscribe to my channel if you haven't done so already, and don't forget to check out my website, nexusnursinginstitute.com. There you can sign up for a part one or part two Next Generation NCLEX review session. In part one, I teach you how to think like the test writer.
I teach you how to think critically. I teach you about prioritization, delegation. And in part two, we actually go over questions that include important content that you need to know for your exam. If you're a current nursing student, I have something for you. I have audio lessons.
Be sure to check that, especially if you have to get a really high grade on your next exam. be sure to check out the audio lessons I have available. Almost daily, you can find me covering a variety of nursing topics across my social media platforms, such as TikTok, Instagram, Facebook, and of course, right here on YouTube.
My handle is the same everywhere, Next Nursing. And without any further ado, let's get started. All right, first question. A patient's prescribed fluconazole. Which of the following statements by the...
a patient indicates a need for further teaching. Here are the options. I should avoid alcohol while taking this medication. I'll continue taking this medication until my symptoms go away.
I might experience some GI side effects like nausea. I'll report any yellowing of my skin or eyes to my healthcare provider. Very good. I will continue taking this medication until my symptoms go away.
And I'm very concerned because 22, 16, 18 of you guys chose the wrong answer. So let's talk about this. First of all, glucanazole, look at what it's ending in.
Zole, Z-O-L-E. This is what type of agent. This is an antifungal agent. Okay.
You do not take the medication until your symptoms go away. Then you stop because you don't want to know what's going to happen. That fungus is going to come back and it's going to come back stronger. and it's going to be harder to kill.
And guess what? Fungus is already hard to kill. It takes a long, long, long, long time of treatment to kill fungus.
All right. We don't need to make it any harder. All of the other choices are good choices. That's why we're not choosing it. Whenever you get a question to ask you, which one requires further teaching, which one requires evaluation, which one would you question, which one requires clarification, what the question's really asking you.
is which is the wrong answer choice. All of the options are good. I will avoid alcohol while taking this medication. Guess what? There is no medication on this earth that you're supposed to be drinking alcohol.
So that's good teaching. I might experience some GI side effects while taking this medication like nausea. Guess what? 99% of the drugs on the market, if you have no idea, What a side effect is, usually nausea and vomiting is going to be a side effect.
Nausea, vomiting, diarrhea, right? Usually there are going to be some GI side effects, especially if that medication is taken orally. So that's a good teaching.
And last, I'll report any yellowing of my skin or eyes to the healthcare provider. Absolutely. What does that mean?
That yellowing of the skin or eyes jaundice, right? What do you think is affected? Liver.
Lots of medication will cause hepatotoxicity, damage to the liver. Think about it. The liver is responsible for metabolizing drugs.
So the two organs that drugs are going to hit the hardest are going to be your liver, hepatotoxicity, and your kidneys. You're going to be dealing with nephrotoxicity. Why? While the liver is responsible for metabolizing these drugs, the kidney is responsible for what? Excretion of the drugs.
Okay. How are you guys doing on the live? All right, let's keep going. Next, second question.
It says, a nurse is administering Amfotericin B to a patient. Which of the following adverse effects should the nurse monitor for? Here are your options. Hypertension and bradycardia, fever, chills, and hypotension, hyperkalemia and hyperglycemia, or rash and photosensitivity. What do you guys think?
Wow. Okay, let's talk about this. I'm happy I did this Kahoot with you guys tonight.
The correct answer is fever, chills, and hypotension. So let me talk to you about some adverse effects of this medication, then I'll come into this answer. When it comes to Amphotericin B, you expect that patient to have symptoms, hepatotoxicity, nephrotoxicity. hypokalemia, tachycardia, those are all symptoms, but also infusion reaction. That is specific to amphotericin B.
We're going to be concerned with infusion reaction. So the signs and symptoms that we see with that is going to be fever, chills, hypotension. Okay. That is specific to that medication.
All right, patients receiving nystatin oral suspension for oral candidiasis. What should be taught about administration of this drug, of the nystatin? Here are the options.
Swallow the medication immediately after rinsing the mouth. Take the medication on an empty stomach to increase absorption. Mix the medication with food or water to reduce the bitter taste, or swish the medication in your mouth for several minutes before swallowing. Very good. I even gave you guys a hint.
I gave you the picture with the tongue out, right? So this page, that picture with that white film on the tongue, what is that on that patient's tongue? Can you guys tell me in the live? What is that? Nobody.
Thank you. Thrush. Thrush is an opportunistic infection. It's a fungal infection. So, you know, usually what happens if patients on antibiotics, what happens is antibiotics, it kills the bad bacteria, but it kills the good bacteria too, right?
So your normal flora goes away and it creates a perfect environment for fungus to grow. That's the rush. Okay. So Nystatin, that is an antifungal medication. So it makes sense.
You know, you're going to have that patient switch that medicine in their mouth. for several minutes. We want to make sure that medicine gets everywhere in that mouth so that it can coat the areas that it needs to coat.
All right. Patient with a UTI is prescribed ciprofloxacin. Which of the following statements by the patient indicates a need for further teaching? I'll drink plenty of water while taking this medication.
I can take this medication with food if it upsets my stomach. I should avoid the sun exposure or use sunscreen when outside. I can stop taking the medication once I feel better.
How are you guys doing on the live? Okay, very good. If that patient says, I can stop taking that medicine once I feel better, uh-oh. That needs further follow-up.
Why? Because it's wrong. This is an antibiotic. And to be more specific, it's a fluoroquinolone, okay? The patient needs to take the entire course of their medication.
And guys, this goes across the board. I know we're talking about Cipro, but across the board, you're going to teach that patient to take the medication as ordered, even if you're feeling better. All of the other options are good.
Yes, drink plenty of water. Why? We're trying to flush the kidneys. We don't want the patient to have any kidney issues.
We need them to be able to excrete the medication appropriately. I can take this medication with food if it upsets my stomach. Yep. And I should avoid the sun.
Why? Because I should avoid the sun or where sunscreen went outside. Absolutely. Because one of the adverse effects of this particular drug is photosensitivity.
By the way, guys, I chose these topics that we're talking about. Very carefully. If you're new to my page or my channel, I don't believe in fluff. I give you the meat and potatoes.
So if it's coming out of my mouth, if it's typed on the screen, if I'm talking about it, I guarantee you, you're going to interact with this information sometime within your academic career. You need to know this stuff. I don't, I don't give fluff.
Make sure you know what I'm talking about. All right. Next question. A nurse is providing discharge teaching about amoxicillin.
Which of the following statements should be included? Here are your options. You can save any leftover medication for further infection.
Take the medication with a glass of milk to prevent a stomach upset. If you develop a rash, stop taking the medication and call your healthcare provider. If you miss a dose, take two doses together to catch up. What do you guys think? Very good.
If you develop a rash, stop taking the medication. and call your healthcare provider. Amoxicillin is one of those antibiotics that many people just do have allergic reactions.
So if it's the first, maybe even second time that the patient's taking that medication, if they develop a rash, they may possibly be allergic to that medication. They need to stop taking that medication immediately and call the healthcare provider. That is an adverse reaction.
You guys need to know the difference between side effects and adverse reactions. They are not the same thing. Side effects are things that can possibly happen to the patient. And you warn the patient this can possibly happen to you because you don't want them to stop taking their meds.
So you tell them in advance so they can expect it, right? Adverse effects, which is worse, are things that could possibly happen to the patient that we do not want to happen to the patient under any circumstances. And you tell that patient, if this happens, you need to let us know right away because you're expecting the health care provider to either change the medication, change the dosage, to do something.
All right? So that's the correct answer. And, of course, you're never going to tell them. The patient, if you miss a dose, take two glasses.
Excuse me. If you miss a dose, take two doses together to catch up. Are you kidding me? Take two doses to catch up. So you're playing doctor now.
The doctor ordered this medication to be once a day or twice a day. And you won't turn around and tell them, oh, if you miss a dose, just take twice. You're changing the frequency of that medication. You are stepping out of your scope of practice. So you can't say that.
You're not going to tell them to take the medication with a glass of milk to prevent stomach upset. And of course, you can't tell them to save any leftover medication. What leftover medication?
Because if I prescribe for you to take one a day for 10 days, guess how many you're getting? 10. If you take that medication the way you were supposed to, why do you have medication leftover? One of the things you have to teach a patient, especially when it comes to antibiotics, even if you're feeling better, take the entire course.
Don't try to save the rest for a rainy day. Because the infection can come back and it can come back worse. Okay.
All right. Patients receiving vancomycin intravenously and they develop flushing and redness. Which of the following actions should the nurse prioritize? Here are your options.
Slow the rate of infusion. Stop the, excuse me, administer an antihistamine. Apply cold compresses to the flush area.
Discontinue the medication immediately. And even though I wrote this question, I still love it. Because I'm about to teach you guys something tonight.
Because I know what you guys are going to go for. And this is why you need to think critically. Ooh, and you did not let me down.
Look at this. 70 of you chose. discontinue the medication.
And I know why you chose that. That's why I put it as an option. Because you remember Professor D ramming this down your throat saying, if something's harming your patient, what's the first thing you do?
You stop it. Absolutely. That's true.
But is this medication harming your patient? The patient's getting IV vanco and they're flushing and they're turning red. Why are they flushing in there?
they're turning red. It's not the medication that's making them flush and turn red. It's the speed of infusion. This is called red man's seat syndrome.
The speed of the infusion is causing that patient to flush and turn red. And so what happens is that patient's body starts to, um, release, um, histamine. And so, because we understand that vancomycin, if it's, if it's, um, infuse too quickly, it can cause Redman syndrome, which is what we're seeing here. Usually, what are we going to do?
We're going to premedicate that patient. We're going to give them antihistamines before we give the infusion. And if it still happens, we're going to slow down the infusion.
We're still going to call the healthcare provider and let them know, you know, this is what we saw happen and we slowed the infusion down. Do you want any other orders? Yes, we're still going to call the healthcare provider, but you're not going to discontinue it.
the medication. And this is why critical thinking is so important. And Plex wants to see if you can think critically or if you're trying to just be a robot and just have everything in a box.
If it was the medication that was harming the patient, absolutely, you would discontinue the medication. But it's not the medication that's harming the patient. It's the speed of infusion.
So this is something very important that you need to know that is specific for vancomycin. Some other things you've got to know specific to vancomycin while I'm talking about it. You need to know that it's very, very, very harmful on the kidneys and liver. And it's very, very, very harmful. um to the patient that it can cause them to lose their hearing we gotta be very careful okay so make sure you know this how are you guys doing on the live all right let's keep going true or false erythromycin is a fluoroquinolone agent is this true or is this false False.
Very good. It's a macrolide. Professor D, do I have to know that drug class? Absolutely. And guys, let me tell you something.
It's much easier to learn the side effects, the adverse effects of nursing interventions, the patient teaching of the drug class than every single specific med. Okay. But absolutely you have to know the drug class is a macrolide and this type of drug is given, you know, to treat, you know, some specific. respiratory infection, some STDs, things like that.
But you do have to know that. True or false? Doxycycline is a tetracycline agent. Is this true or is this false? You're welcome, Irie.
Very good. True. Doxycycline. Tetracycline.
Yes, it's a tetracycline. Now that T in tetracycline, when you think of tetracycline, I want you to think of teratogenic agent. What does that mean?
Teratogenic, harmful to the fetus. Before a healthcare provider orders doxycycline to a female patient of childbearing age, age, guess what tests they're going to do. You guys know what tests that's right. HCG because a teratogenic age, it can cause birth defects.
Okay. It can cause, um, harm to, you know, the forming teeth bones, that baby's going to be born and come out with seven eyeballs. Like don't play.
Okay. It's harmful to the fetus. So you cannot take this if you are pregnant.
Yep, teeth and bones, Donna. All right, type in your answer. Which cranial nerve number? So just type in the number. Which cranial nerve number should you assess for the patient getting an aminoglycoside?
Type in your number. You guys are doing great on the live. Now, do you know the name of that nerve?
You guys seem to know the number. Do you know the name? Trochlear, one, seven, three, four, five, 11. Okay, the correct answer is eight. You guys were all over the place with that one, but the correct answer is eight.
And the name of it is vestibulococular, okay? Now what it does, this nerve, it transmits sound and equilibrium because that's important for what? Balance from the inner ear to the brain. That's very important. Excuse me.
Cephalosporins should be taken on an empty stomach. Is this true? False. Is this true only if a fever is present or sometimes?
Cephalosporin should be taken on an empty stomach. What do you guys think? False, false. It should be taken with food. And not only that, something you got to remember about cephalosporins, there is a cross sensitivity to, what's that drug class?
To penicillin. Okay. So if a patient has had an adverse reaction to penicillin, Are you going to give them the cephalosporin just because the doctor or the nurse practitioner or the PA, whoever, the healthcare provider ordered it? Absolutely not.
What you're going to do is withhold that medication, pick up the phone and call the healthcare provider and say, hey, I know you ordered the cephalosporin, but are you aware that this patient is allergic to penicillin? Okay. If a patient has an allergy, there's a, just chemically speaking, there's a portion of penicillin that. You also find encephalosporins, and we don't know what part the patient was allergic to, so we don't take any chances, especially when there are so many other types of antibiotics on the market that can get the job done. All right, which adverse reaction to level of fluxason should be prioritized?
Headache, nausea, diarrhea, or calf pain? What do you guys think? Chrissy, don't play.
You too, Naza. All right, guys, let's talk about it. Very good.
Most of you guys chose Calf Pain. Now. For the three that chose nausea and the 10 that chose diarrhea, remember, I forget how many slides ago, I said to you the most common side effects that we'll see, nausea, vomiting, diarrhea, you know, I'm not saying never, but not too often do we see nausea or diarrhea as an adverse effect.
Okay. For it to be an adverse effect, what we say, if this happens, call us, let us know right away, because we got to do something about it. That nausea or diarrhea has to be what? Severe, not just regular nausea, diarrhea, because that is so common, right? It would have to be severe to be considered an adverse effect.
Headache. Headache isn't as common a side effect, but again, that's a side effect. Some meds is considered.
um, an adverse effect if it's severe enough, but let me tell you what that calf pain represents. The patient's been on a level of fluxation and they call and say, Oh, you know, I'm having, you know, pain in my left calf or my right calf. You better suspect tendon rupture.
That is a medical emergency. You tell that patient to come in right away. Okay. So whenever you get a question about what are you going to prioritize when you see that word or you hear that word prioritization, You have to think to yourself, what is going to kill my patient the fastest? Okay, last question.
Which is not an example of a super infection? We got C. diff, thrush, yeast infection, hypertension. Which is not an example of a super infection?
I don't understand how six of you guys chose thrush. I went over thrush with you. I told you it's opportunistic infection.
Why would you choose that as a super infection? C. diff, super infection. Thrush, super infection. Yeast infection, super infection.
Not hypertension, okay? Hypertension is the only one that is not a super infection. All right, let's see how you guys did.