Exam 59: Penicillins

The primary care NP administers penicillin G (Bicillin)to a 75-year-old patient who has COPD and heart failure.The patient takes digoxin,warfarin,and spironolactone.To help prevent drug interactions,the NP should order:

A patient with group A b-hemolytic streptococcal pharyngitis is treated with penicillin V.At a follow-up visit 2 weeks later,the patient presents with edema of the hands and feet,blood pressure of 140/85 mm Hg,and cola-colored urine.A urine dipstick shows proteinuria.The primary care NP should:

A patient is taking dicloxacillin (Dynapen)500 mg every 6 hours to treat a severe penicillinase-resistant infection.At a 1-week follow-up appointment,the patient reports nausea,vomiting,and epigastric discomfort.The primary care NP should:

A sexually active woman is being treated for streptococcal pharyngitis.The patient takes oral contraceptive pills (OCPs).Which penicillin should the primary care NP prescribe for this patient?

A patient with otitis media is treated for 10 days with amoxicillin.At the follow-up visit,the primary care NP notes bilateral erythematous,bulging tympanic membranes.The NP should prescribe:

A patient was seen in a local emergency department and was treated empirically for pharyngitis with ampicillin and comes to the clinic 2 days later with an urticarial rash.The patient has no previous history of atopy and does not have respiratory symptoms.The primary care NP should suspect:

A primary care nurse practitioner (NP)sees a 3-year-old child who has a history of recurrent otitis media.The child's parent tells the NP that the child is allergic to penicillin.The NP learns that the child developed an all-over rash 2 days after starting amoxicillin at age 2 years.The NP should: