PrepU Pharm Assignment 1

A client with a urinary tract infection has been advised that cranberries, cranberry juice, and extra fluids may assist in relieving symptoms. What statement by the client would indicate a need for further instruction?

"I don't like cranberries so I will take a cranberry capsule."

Which statement by a client taking a sulfonamide requires further instruction?

"I will make sure to use extra sunscreen when I go to the tanning booth."

The nurse receives a call from a client who is on sulfasalazine therapy. The client states, "My urine looks orange. What should I do?" What is the nurse's best response to this client?

"This is a normal reaction caused by the medication. It will go away when you finish taking the medication."

Which of the following are ways in which microbes enter the body? (Select all that apply)

-Break in the skin -Ingestion -Breathing -Mucous membrane contact

The nurse knows that the recommended time to administer a sulfonamide to a patient is which of the following?

1 hour before or 2 hours after meals

The patient is ordered sulfasalazine 500 mg QID. The drug comes in 1000-mg tablets. How much should the nurse adminster to the patient at each dose?

1/2 tablet

A patient has been recommended 1500 mg of sulfasalazine oral suspension every 24 hours. The available drug is in the form of a 500 mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each day.

3

A patient 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 nursing student learning about anti-infective therapy demonstrates understanding when she defines "bacterial resistance" as which of the following?

Ability of bacteria to produce substances that inactivate or destroy the antibiotic

The nurse is caring for a client who has developed leukopenia a result of long term sulfonamide therapy. What is the most important nursing intervention in light of this client's condition?

All individuals in contact with the client must perform frequent hand hygiene.

A client who has been on long-term sulfonamide therapy has developed both anemia and leukopenia. The nurse knows that this combination of problems is known as what disorder?

Aplastic anemia

The ability of bacteria to produce substances that inactivate or destroy the antibiotic is known as which of the following?

Bacterial resistance

The nursing instructor is teaching about anti-infectives and realizes further instruction is needed when a student makes which of the following statements?

Bactericidal means they slow or retard the multiplication of bacteria.

Drugs that destroy the bacteria are known as which of the following?

Bacteriocidal

The nurse is caring for a client who has been on sulfonamide therapy for six months. What sign/symptom would the nurse report to the health care provider immediately?

Bruises

The nurse is applying mafenide (Sulfamylon) to a client's burned skin and knows that which adverse reactions may occur with this medication? Select all that apply.

Burning sensation Itching Rash

Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?

Cleanse the wound of debris prior to applying the silver sulfadiazine

Some patients stop taking their prescribed sulfonamide once symptoms disappear. What should the nurse tell the patient when first teaching about this medication to prevent the early discontinuation of the drug?

Failure to complete a course of therapy may result in a recurrence of the infection.

The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?

Fear of incontinence.

A client asks the nurse if it is safe to take Goldenseal (Hydrastis canadensis) as a treatment for a sinus infection. The nurse will counsel the client against taking this herb if the client has what condition?

Hypertension

A patient with diabetes who controls his disease with an oral agent and diet has been hospitalized with a urinary tract infection. The physician has ordered sulfasalazine 500 mg QID. Which of the following should the nurse closely monitor for in this patient?

Hypoglycemic reaction

The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action?

Inflammation is decreased because of interaction with intestinal bacteria.

The nurse is assisting in the admission of a client with a suspected urinary tract infection. 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.

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

Renal

A 55-year-old woman has recently begun treatment for a UTI with SMZ-TMP. When planning this patient's care, what nursing diagnosis should the nurse prioritize?

Risk for Impaired Tissue Integrity related to drug-induced photosensitivity

A client is given sulfasalazine to treat his/her ulcerative colitis. The client begins to complain of flu like symptoms (fever, cough, headache, and muscle aches and pains). The nurse notices red wheals on the client's face and neck. What type of reaction could the client be experiencing after taking sulfasalazine? (Choose one)

Stevens-Johnson syndrome

The nurse is caring for the following clients and is aware that sulfonamides should be used cautiously in which client?

The client with asthma

The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition?

Ulcerative Colitis

A nurse is monitoring a patient on sulfonamide therapy. Which of the following symptoms should the nurse assess to find out if the patient has thrombocytopenia?

Unusual bleeding

The nursing instructor is teaching about anti-infectives and informs students that viruses have been difficult to treat in the past. He indicates the reason for this to be which of the following?

Viruses have the ability to change because they use DNA and RNA of other cells.

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the physician if the client experiences what adverse effect associated with the drug?

skin rash or itching

The client has completed a course of sulfonamide therapy and the nurse knows that continued inspection of the skin is required for how long after the end of treatment?

two weeks

The nurse instructs a patient 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 of the following complications associated with sulfonamide therapy?

Crystalluria

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 of the following nursing diagnoses would receive high priority for a burn patient on sulfonamide therapy?

Impaired skin integrity

The nursing student is studying about sulfonamides and learns that their mode of action is which of the following?

Inhibit the activity of folic acid in bacterial cell metabolism

A client with a urinary tract infection is being treated with a sulfonamide antibiotic. The nurse should recognize that pathogens are being eradiated by what means?

Inhibition of folic acid synthesis

A nurse is caring for a patient with crystalluria. Which of the following interventions should the nurse perform to prevent more stones from forming?

Instruct the patient to increase fluid intake to 2000 mL

A nurse is helping with the discharge of a 92-year-old female patient who has been hospitalized for a serious upper urinary tract infection. The patient will continue taking SMZ-TMP at home. She is to be discharged into her daughter's care. The nurse will instruct the daughter to watch for which of the following most common adverse effects of the drug?

Nausea and vomiting

A patient is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this patient?

Renal damage

A patient is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole (Bactrim). What assessment should the nurse make prior to the administration of the medication?

Renal insufficiency

The nurse understands the risk of patients developing a "superinfection" when taking an anti-infective. A superinfection can best be defined as which of the following?

Secondary infection caused by a disruption of normal flora

Which category of antimicrobial agents is used chiefly because of low cost and effectiveness in treating common bacterial infections?

Sulfonamides

The nurse working in the burn unit is preparing to change a patient's dressing for the first time. What should the nurse tell the patient before changing the dressing and applying the ordered mafenide (sulfamylon) ointment?

That stinging or burning may be felt during and after application of the ointment

The nurse is admitting a client with a urinary tract infection who has been prescribed sulfadiazine. What information obtained in the admission process would cause the nurse to contact the health care provider immediately?

The client is currently taking warfarin (Coumadin).

The patient who has been on long-term sulfonamide therapy begins to bruise easily and have some bleeding from the mucous membranes. The nurse knows that these symptoms reflect which of the following complications attributed to sulfonamide therapy?

Thrombocytopenia

A patient has sustained a burn from a gas grill. She has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection?

Topical

The nurse is caring for a client with a urinary tract infection caused by Escherichia coli and expects the health care provider to order which sulfonamide?

Trimethoprim (TMP) and sulfamethoxazole (SMZ)

The nurse is caring for a client who is taking a sulfonamide and notices that the client has developed itchy hives. After contacting the health care provider, what term will the nurse use to describe the client's symptoms?

Urticaria

The nurse is caring for a patient with a urinary tract infection (UTI) being treated with a sulfonamide. The patient asks for something to drink. Which of the following options should the nurse give to the patient?

cranberry juice

The nurse is applying silver sulfadiazine (Silvadene) to a client's burn when the client states, "Every time you put that on me it burns." What is the nurse's best response?

"I'm sorry that it hurts, but many clients report a burning sensation when this medication is applied."

Mr. Martin has been prescribed SMZ-TMP for a urinary tract infection. Mr. Martin has a history of hypertension, allergic reactions to furosemide, and smoking (1 pack of cigarettes per day). Two days after starting therapy, Mr. Martin develops an itchy rash on the trunk of his body. How would you explain to Mr. Martin what has occurred?

"You are having an allergic reaction to the medication and need to stop taking it immediately."

The nursing instructor is teaching the nursing students about serious hematologic adverse reactions that can occur with prolonged sulfonamide therapy. Which of the following should be included? (Select all that apply.)

-Leukopenia Thrombocytopenia -Aplastic anemia

The nurse has learned that some patients should not take sulfonamides. These include which of the following patients? (Select all that apply.)

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

A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide?

10 lb weight loss

The nurse is caring for four patients on a medical floor. For which of the following patients would she suspect the physician might order a sulfonamide?

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

Drugs that slow or retard the multiplication of bacteria are known as which of the following?

Bacteriostatic

Sulfonamides are classified as which of the following? (Choose one)

Bacteriostatic

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

Both gram positive and gram negative

The primary healthcare provider has prescribed mafenide for a patient with second-degree burns. Which of the following is the most frequent adverse reaction associated with the topical application of mafenide on the affected area?

Burning sensation during application

The nurse understands that the most frequent adverse reaction seen with the topical application of a sulfonamide is which of the following?

Burning sensation or pain