NCM 106 - PHARMACOLOGY

CASE STUDY: CLIENT WITH A PSEUDOMONAL INFECTION

DIRECTION: Read and analyze the case. Answer the accompanying questions.

FSH, 46 years old, has a wound infection. The culture report stated that the
infection was due to Pseudomonas aeruginosa. FSH’s temperature was 104 ℉
(40 °C). Amikacin sulfate (Amikin) is to be administered intravenously in 100
mL of Dextrose 5% in Water over 45 minutes every 8 hours. Dosage is 15
mg/kg/day in three divided doses. FSH weighs 165 lb.

1. What is the drug classification of Amikacin? How many

milligrams of Amikacin should FSH receive every 8 hours?

Amikasin sulfate is classified as an antibiotic. Amikacin

sulfate belongs to the aminoglycoside antibiotics class of
drugs. It works by killing bacteria or preventing their
growth and is used to treat serious bacterial infections in
many different parts of the body.

The client should receive 374 milligrams every 8 hours.

2. What type of intravenous infusion should be used? What

would be the IV flow rate?

22 or 23 gauge and 1-1.5inches long needle should be

used.

3. Why should a wound culture be taken before determining the

antibacterial agent?

Acquiring samples prior to the administration of antibiotics

allows healthcare providers to identify the pathogenic
microorganisms that caused the infection. This also helps to
improve patient treatment by determining which antibiotic
would be most effective in treating the infection and healing
the wound. The infection was caused by Pseudomonas
aeruginosa, according to the culture results. The physician
then directed that the recommended antibiotic, Amikacin
sulfate, be administered by IV infusion.
4. What should a hearing assessment include?

Because of the increased risk of ototoxicity, the nurse should

assess FSH's hearing before and after therapy. Especially if the
patient will be getting the medicine for more than two weeks to
identify hearing damage. This is because drug-induced damage
to these auditory and balance system components can result in
hearing loss, tinnitus, and disequilibrium or dizziness.

5. FSH’s urine output in the last 8 hours was 125 mL. Explain the
possible cause for the amount of urine output. What nursing
action should be taken?

When the antibiotic Amikacin is used, there are certain side

effects. There is an increase in urine excretion of casts,
nephrotoxicity, and azotemia in GU or genitourinary. Because
of the increased risk of nephrotoxicity, the nurse should treat
dehydration before starting medication and monitor renal
function, including urine output, specific gravity, urinalysis,
BUN and creatinine levels, and CrCl. Nephrotoxicity is defined
as a fast decline in kidney function caused by the toxic effects
of medicines.

6. What laboratory tests indicate renal function?

Urinalysis, BUN and creatinine levels, urine output, specific

gravity, and CrCl are all laboratory tests that reflect renal
function.

7. The physician requests peak and trough serum amikacin levels.

When should the peak serum level and trough serum level be
drawn?

Collect blood 30 minutes to 1 hour after the IV infusion stops

for peak levels; draw blood soon before the following dosage
for trough levels. 1 hour after the IM injection, take a blood
level.
REFERENCES:

Lippincott, W., & Wilkins (2022). Nursing 2022 drug

handbook. 42nd edition. Philadelphia: Wolters Kluwer

Al-Naimi, M. S., Rasheed, H. A., Hussien, N. R., Al-Kuraishy, H.

M., & Al-Gareeb, A. I. (2019). Nephrotoxicity: Role and
significance of renal biomarkers in the early detection of acute
renal injury. Journal of advanced pharmaceutical technology &
research, 10(3), 95–99.
https://doi.org/10.4103/japtr.JAPTR_336_18

NCM 106 - PHARMACOLOGY