18 Oct A 16 year old male is admitted to the step down unit following laparotomy for appendici-tis. It was determined during surgery that the appendix had ruptured causing a perito-nitis.

A 16 year old male is admitted to the step down unit following laparotomy for appendici-tis. It was determined during surgery that the appendix had ruptured causing a perito-nitis. What antibiotics would be indicated to treat the peritonitis?                                     

Question 2This is a sensitivity report for a 45 year old male. What antibiotic would you not order to treat this infection? Would ciprofloxin with a MIC of 1 be more effective than aztreonam with a MIC of 8?                                   

Question 3          A 42 year old female has a severe bacterial infection. She is being treated with a broach spectrum IV drug. The drug is administered too rapidly causing hypotension, flushing and itching over the upper portion of her chest, neck, and face. What antibiotic is likely responsible for these symptoms?                                        

Question 4          A 42 year old man is evaluated for redness, pain, swelling, and tenderness on the anterior right thigh. His symptoms started about 4 days ago with a small 1 cm blister on his thigh. The area has gotten bigger over the past 4 days and is now 4 cm x 6 cm. He indicates that has been having fever and chills over the past couple of days. The NP diagnoses him with cellulitis. What would your treatment for this be?                                         

Question 5          A 52 year old female is 7 days post lumbar laminectomy complaining of abdominal pain and severe diarrhea. She is afebrile with stable vital signs. Lab results show a positive C-diff culture. How should you treat this patient?                                           

Question 6          What factors are considered when making empiric antibiotic decisions? Apply those factors to a patient with suspected acute otitis media.                                          

Question 7          A 20-year old woman was seen by her primary care provider last week and diagnosed with a lower track UTI. Her complaints at that time included burning on urination, frequent urination of a small amount, and superpubic pain. She was prescribed a 3 day course of Bactrim which she completed. She is admitted to the step down unit today with complaints of fever (102.6 and above) for the past 24 hours and CVA tenderness. She appears very ill and is somewhat confused today. Her BP is 100/62. Her family indicates that she has been vomiting for the last 24 hours and been unable to keep food or fluids down.

What would your initial plan for this patient include?                                      

Question 8          A 54 year old women is 7 days post op following a breast lump removal. She complains of pain, redness, and swelling around her left breast incision. She has a low grade temperature (99.6). The NP determines that she has a post operative wound infection. What antibiotics would be indicated to treat her infection?       

Question 9          A 37 year old man is currently admitted to the step down unit. He was involved in a motor vehicle crash last week and has been intubated in the ICU for the last week. The endotracheal tube was removed 2 days ago. Today he complains of purulent green nasal drainage, headache, sinus tenderness, and his teeth hurting. The NP diagnosis him with acute bacterial rhinosinusitis. How would you treat the rhinosinusitis?                                   

Question 10        A 26 year old male is scheduled for a lumbar laminectomy tomorrow. Penicil-lin causes a rash in this patient. His preoperative orders include cefazolin 2 gm IV to be given on call to the OR. The NP is called to change the antibiotic order due to the patients allergy. What is the best action for the NP to take?