Otherwise, this can lead to undertreatment or ineffective treatment if not main-
tained. Sometimes a double dose of an antibiotic is administered as the first dose
to quickly achieve a therapeutic level. This is called a loading dose.
Intramuscular injections of antibiotics should be given deep into the muscle
and sites should be rotated if more than one injection is prescribed. Stop orders
and the need for renewal orders will depend on the healthcare agency policy.
However, it is common that antibiotic orders are for 72 hours only until the
results of a culture and sensitivity test can be obtained. Antibiotic prescriptions
are usually not renewed. This is an effort to limit the opportunity for the micro-
bial to become resistant to the medication.
In severe cases, aggressive treatment is necessary to control the growth and
destroy the microbial quickly. To do this, the medication is administered par-
enterally in an IV dose that is diluted in a neutral solution (pH 7.0 to 7.2) such
as normal saline (N.S.) or isotonic sodium chloride or 5% dextrose and water
(D5W). Antibiotics should not be mixed together or administered at the same
time. They can be administered as a piggyback infusion. Information about how
long an interval should occur between the infusion of different antibiotics should
be obtained from the pharmacy or the drug insert.
The following nursing diagnoses can be used for patients who are taking
antibiotics:- Risk of infection related to treatment failure or superinfection.
- Risk of fever related to treatment failure or superinfection.
- Risk of fluid volume deficit related to adverse GI reaction such asanorexia,
nausea/vomiting/diarrhea, and complications of allergic reaction.
They are also at risk for having the following collaborative problems:- Sepsis
- Ototoxicity (ears)
- Blood dyscrasias
- Nephrotoxicity (kidney)
It is critical that the patient be given information on the management of his or
her condition. These instructions include:- Take all the medication even after the symptoms subside.
- Do not take medication that is left over from a previous illness. (The med-
ication may not treat the patient’s condition or may have lost its therapeu-
tic capabilities.)
(^208) CHAPTER 13 Antimicrobials—Fighting Infection