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Advise patient to notify provider if no improvement is noticed after 2-3 weeks of therapy or if fever, anorexia, malaise, N, V, darkened urine, yellowish discoloration oft he skin and eyes, pain or swelling of joints occur.

Use sunscreen to prevent photosensitivity reactions.

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Nursing Implications:

Assess for infection (vital signs, wound appearance, sputum, urine, stool, WBC) at beginning of and throughout therapy.

Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

Evaluate eighth cranial nerve function by audiometry before and throughout therapy. Hearing loss is usually in high-frequency range. Prompt recognition and intervention are essential in preventing permanent damage. Monitor for vestibular dysfunction (vertigo, ataxia, nausea, vomiting). Eighth cranial nerve dysfunction is associated with persistently elevated peak aminoglycoside levels. Aminoglycosides should be discontinued if tinnitus or subjective hearing loss occurs.

Monitor intake and output and daily weight to assess hydration status and renal function.

Assess for signs of superinfection (fever, upper respiratory infection, vaginal itching or discharge, increasing malaise, diarrhea).

Patient Teaching:

Explain the purpose of gentamicin to patient.

Instruct patient to report signs of hypersensitivity, tinnitus, vertigo, hearing loss, rash, dizziness, or difficulty urinating.

Advise patient of the importance of drinking plenty of liquids.

Teach patients with a history of rheumatic heart disease or valve replacement the importance of using antimicrobial prophylaxis before invasive medical or dental procedures.

Rep:  May cause fetal harm. Advise females of reproductive potential use effective contraceptives during therapy and to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Monitor breastfed infants for thrush and diarrhea.

Topical Instruct patient to wash affected skin gently and pat dry. Apply a thin film of ointment. Apply occlusive dressing only if ordered by health care professional. Patient should assess skin and inform health care professional if skin irritation develops or infection worsens.

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Patient prescribed metronidazole 750 mg by mouth three times daily for a skin tissue infection due to Peptostreptococcus bacteria

PO Administer on an empty stomach, or may administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty swallowing

DNC: Swallow extended-release tablets whole; do not break, crush, or chew

do not drink alcohol while taking this medication

may cause an unpleasant metallic taste

take as directed, evenly spaced time in between doses

notify provider if a rash occurs

advise patient frequent mouth rinses, good oral hygiene, and sugarless gum or candy may minimize dry mouth

may cause urine to turn dark

Advise patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black, furry overgrowth on tongue; vaginal itching or discharge; loose or foul-smelling stools) develop

Rep: Advise females of reproductive potential to inform health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy

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15-30 mg/kg/day as a single dose for 2 months of a 6 month regimen, must be taken with other medicines to treat TB such as isonizad

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Enforce gloves and gown usage and hand washing with soap and water before and after contact with patient. Patient must wash hands after each bathroom usage and before and after meals.

Visitors should not use same bathroom or utensils as patient.

Encourage patient to complete antibiotic treatment even if symptoms improve and implement a pro-biotic to support extra good bacteria in the gut.

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vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and during therapy.

Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.

Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of Clostridioides difficile-associated diarrhea (CDAD). May begin up to several wk following cessation of therapy

Patient teaching:

Hydration

Position: semi-fowlers position to help breathing and expand lungs

Incentive spirometer

Hand washing

cover mouth and nose while cough

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TEACHING : Advise patient to take medication 2x daily for 5 days. If patient missed a dose, advise patient to take missed does as soon as remembered.

INTERACTIONS : May ↓ the therapeutic effect of  influenza virus vaccine ; avoid use 2 days prior to and 2 wk after vaccine administration.

NURSING IMPLECATIONS : PO May be administered with food or milk to minimize GI irritation.

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Perform mycobacterial studies and susceptibility tests before and periodically during therapy to detect possible resistance.

Lab test: Monitor hepatic function before and every 2-4 weeks during therapy

Monitor serum uric acid

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Take missed dose as soon as remembered, notify if no improvement is seen within a few days. Report signs of hypersensitivity, tinnitus, vertigo, or hearing loss.

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Vancomycin is an oral antibiotic, used to treat an infection in the intestines caused by clostridium difficile

Nursing Implications

Monitor for decreased frequency of urination

Darkening urine color

peripheral edema

Thirst/Dry skin

Patient Teaching

Do NOT take more or less than what is prescribed to you

Side Effects

low potassium

nausea

stomach pain

Across the lifespan

pregnancy- Only should be used if only clearly necessary

Infant/Children- Just the normal small dose by weight

Geriatric- no contradictions with the medication, some side effects may be more shown in elderly