In which of the following scenarios would the nurse consider antibiotic therapy to be prophylactic? (Select all that apply.)
a. Patient with neutropenia and cancer who experiences fever and cough
b. Patient with a fever of unknown origin
c. Patient undergoing an operation for a compound fracture
d. Patient with an artificial heart valve who is scheduled for hernia repair
e. Patient with a new diagnosis of endocarditis
ANS: C, D
Prophylactic antibiotic therapy is appropriate for patients undergoing an operation for a compound fracture because it is a "dirty surgery." It also is appropriate for a patient with an artificial heart valve who is scheduled for a hernia repair, because it reduces the patient's risk of bacterial endocarditis.
Not enough information is provided to determine whether the patient with neutropenia, cancer, fever, and cough needs antibiotic therapy.
A patient with a fever of unknown origin may or may not need a broad-spectrum antibiotic, depending on the diagnosis.
A patient with a new diagnosis of endocarditis does not need prophylactic antibiotic therapy, because the patient already has an infection. Prophylaxis is given to prevent an infection.
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