Macrolides, Nursing Diagnosis, and Collaborative Problems - Pharmacology

Here are the common nursing diagnoses that are related to a patient who is receiving marolides.

  • Altered bowel elimination pattern
  • Impaired tissue integrity related to inflammation or phlebitis at the injection site
  • Fluid volume deficit related to nausea and vomiting
  • Alteration in comfort related to abdominal cramping
  • Sensory-perceptual disturbance related to hearing loss
  • Altered protection related to loss of normal flora

LINCOSAMIDES

Lincomycin (Lincocin) has been used in the past to treat serious streptococci, pneumococci, and staphylococci infections but has generally been replaced by safer and more effective antibiotics. Clindamycin (Cleocin) is a semisynthetic derivative of lincomycin and has a similar mechanism but is more effective. It is indicated for the treatment of bone and joint infections, pelvic (female) and intraabdominal infections, bacterial septicemia, pneumonia, and skin and soft tissue infections. In a normal dose, lincosamides prevent the growth of bacteria (bacteriostatic). In larger doses, it kills bacteria (bacteriocidal).

The use of lincomycin is avoided because there is a significant occurrence of pseudomembranous colitis. Clindamycin is the drug of choice because it is safer and more effective than lincomycin.

Patient assessment before administering lincosamides is the same as for all antibiotics. In addition, determine if the patient has a history of GI diseases, liver or kidney problems.

Administer lincosamides with a full glass of water or with meals to prevent esophageal ulceration. After lincosamides are administered, request additional white blood count studies to determine the effectiveness of the medication. Monitor the patient for:

  • Abdominal cramps.
  • Diarrhea.
  • Weight loss.
  • Weakness.

The patient should be provided with the same instructions as is given to a patient who is receiving penicillin (see Penicillin and Patient Education).


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