GU

A client with a urinary tract infection is ordered co-trimoxazole (trimethoprim-sulfamethoxazole). The nurse should provide which medication instruction? You selected: "Take the medication with food." Incorrect Correct response: "Drink at least eight 8-oz glasses of fluid daily." Explanation: The nurse should instruct a client receiving a sulfonamide such as co-trimoxazole to drink at least eight 8-oz glasses of fluid daily to maintain a urine output of at least 1,500 ml/day. Otherwise, inadequate urine output may lead to crystalluria or tubular deposits. For maximum absorption, the client should take this drug at least 1 hour before or 2 hours after meals. No evidence indicates that antacids interfere with the effects of sulfonamides. To prevent a photosensitivity reaction, the client should avoid direct sunlight during co-trimoxazole therapy.

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Which of the following nursing interventions is likely to provide the most relief from the pain associated with renal colic? You selected: Administering meperidine (Demerol). Correct Explanation: During episodes of renal colic, the pain is excruciating. It is necessary to administer opioid analgesics to control the pain. Application of heat, encouraging high fluid intake, and limitation of activity are important interventions, but they will not relieve the renal colic pain.

The client with acute pyelonephritis wants to know the possibility of developing chronic pyelonephritis. The nurse's response is based on knowledge that which of the following disorders most commonly leads to chronic pyelonephritis? You selected: Recurrent urinary tract infections. Correct Explanation: Chronic pyelonephritis is most commonly the result of recurrent urinary tract infections. Chronic pyelonephritis can lead to chronic renal failure. Single cases of acute pyelonephritis rarely cause chronic pyelonephritis. Acute renal failure is not a cause of chronic pyelonephritis. Glomerulonephritis is an immunologic disorder, not an infectious disorder.

A nurse is assessing a client with nephrotic syndrome. The nurse should assess the client for which condition? You selected: Massive proteinuria. Correct Explanation: Nephrotic syndrome is characterized by massive proteinuria caused by increased glomerular membrane permeability. Other symptoms include peripheral edema, hyperlipidemia, and hypoalbuminemia. Because of the edema, clients retain fluid and may gain weight. Hematuria is not a symptom related to nephrotic syndrome.

The nurse should teach the client with erectile dysfunction (ED) to alter his lifestyle to: You selected: Avoid alcohol. Correct Explanation: Avoidance of alcohol can improve the outcome of therapy. Alcohol and smoking can affect a man's ability to have and maintain an erection. The client should be encouraged to follow a healthy diet, but no specific diet is associated with improvement of sexual function. The client should cease smoking, not just decrease smoking. Increasing attempts at intercourse without treatment will not facilitate improvement. The client should be reassured that ED is a common problem and that help is available.