NU220 Pharmacology Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics

A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective?

"I will apply it in a very thin layer over the area."

The nurse is providing education to an older adult client who has been prescribed tetracycline. Which statement should the nurse include in the teaching?

"Increase your fluids to 2 L or more per day to prevent renal crystals."

The nurse understands that some clients should not take sulfonamides. These include which clients? (Select all that apply.)

- Clients with a hypersensitivity to sulfonamides -Women who are lactating - Children younger than 2 months

A client has been prescribed 4 gm of sulfamethoxazole-trimethoprim tablets per day. The available drug is in the form of 500 mg. To meet the recommended dose, the nurse will administer _______ tablets each day.

8

The nurse is caring for four clients on a medical floor. For which client would the nurse suspect the health care provider might order a sulfonamide?

A 35-year-old woman with a urinary tract infection and a history of ulcerative colitis

A nurse is caring for a hospitalized client with a urinary tract infection (UTI). The nurse is preparing to administer nitrofurantoin, which is a bacteriostatic antibiotic. Which statement best differentiates bacteriostatic and bactericidal medications?

Bacteriostatic medications slow or retard the multiplication of bacteria.

The pharmacology instructor is teaching about sulfonamides and informs the students that these drugs are used to control infections caused by which bacteria?

Both gram positive and gram negative

A client is started on trimethoprim and sulfamethoxazole for a urinary tract infection. The client reports nausea, anorexia, and abdominal pain. What intervention does the nurse discuss with the client?

Consume the medication with food.

The nurse instructs a client on sulfonamide therapy to drink a full glass of water when taking the medication and to also drink at least 8 large glasses of water each day until therapy is finished. The nurse is trying to prevent which complication associated with sulfonamide therapy?

Crystalluria

A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?

Decreased absorption of tetracycline

The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction?

Hypoglycemia

Which nursing diagnoses would receive high priority for a burn client on sulfonamide therapy?

Impaired skin integrity

The health care professional has recommended sulfonamide therapy for a patient. While obtaining the patient's medical history, the nurse discovers that the patient is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants?

Increased action of the anticoagulant

A client is prescribed methenamine to treat urinary tract symptoms. Which nursing assessment finding would suggest the reason for this medication?

Low grade fever

The nurse informs a client of which are the most common adverse effect of sulfonamide therapy?

Nausea

The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9°F. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?

Obtain urine for culture and sensitivity.

Which drug would the nurse identify as turning a client's urine reddish orange?

Phenazopyridine

The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?

Renal

A nurse is caring for a client with irritation of the lower genitourinary tract. The client is administered phenazopyridine. Which condition in clients contraindicates the use of the drug?

Renal impairment

A nurse is caring for a client receiving nitrofurantoin drug therapy. What instruction should the nurse include in the teaching plan for the client and family? Select all that apply.

Take the drug with food or milk to improve absorption. Continue therapy for at least 1 week. Notify the PHCP in case of fever, chills, or cough.

The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?

Teeth

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

The nurse is caring for a client being treated for urosepsis. The client's medication regimen includes phenazopyridine. What outcome best indicates therapeutic effects of this medication?

The client reports an absence of urinary burning and pain.

The client who has been on long-term sulfonamide therapy begins to demonstrate symptoms associated with side affects of the therapy. The nurse knows that these symptoms are related to which complication associated with sulfonamide therapy?

Thrombocytopenia

Which laboratory test should the nurse monitor to evaluate treatment effectiveness, when a client has been prescribed a medication to manage bladder spasms associated with a urinary tract infection?

Urine culture and sensitivity

The nurse is caring for a client receiving sulfonamides. The nurse will notify the health care provider if which changes are noted in the client's urine output? Select all that apply.

Urine output is decreased. Crystals are present in the urine.

A patient who is on sulfonamide therapy is about to be discharged. Which of the following precautions should the nurse instruct the patient to follow to reduce the effects of photosensitivity?

Wear protective clothing and sunscreen when outside.

The action of sulfonamides is classified as which type of medication?

bacteriostatic

The primary health care provider has prescribed mafenide for a client with second-degree burns. The nurse would be alert for which effect as the most frequent adverse reaction associated with the topical application of mafenide on the affected area?

burning sensation during application

A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component?

fluids

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description?

inhibiting bacterial protein synthesis

When describing the action of sulfonamides to a client, the nurse integrates understanding of the drug's action with effects exerted due to which mechanism?

inhibition of the activity of folic acid in bacterial cell metabolism

A 32-year-old female client has a urinary tract infection. Her record reveals that she has recently been treated for anemia. The health care provider has indicated that drug therapy for the urinary tract infection will last more than 2 weeks. The most important nursing action will be to:

obtain a complete blood count to establish baseline values.

A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?

on an empty stomach.

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?

penicillins

A nurse is caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for:

signs and symptoms of continuing UTI.

The nurse is caring for a client who is taking a urinary anti-infective. What assessment should the nurse prioritize to identify the effectiveness and appropriateness of the client's drug therapy?

urine culture and sensitivity results