renal and urinary medications

Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?

Urinary strictures Bethanechol chloride can be hazardous to clients with urinary tract obstruction or weakness of the bladder wall.

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation?

Urination is not painful. Phenazopyridine is a urinary analgesic. It is effective when it eliminates pain and burning with urination

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy?

Sore throat Clients taking trimethoprim-sulfamethoxazole should be informed about early signs and symptoms of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the health care provider (HCP) if these occur.

The nurse provides instructions regarding the administration of liquid oral cyclosporine solution to a client. Which statement, if made by the client, would indicate the need for further teaching?

"I will purchase a dropper from the pharmacy to calibrate the amount of medication that I need." The client needs to be instructed to dispense the oral liquid into a glass container using a specially calibrated pipette.

The nurse is providing teaching for a client prescribed ciprofloxacin for a urinary tract infection. Which statement made by the client indicates that there is a need for further teaching?

"If I develop any tendon pain while taking ciprofloxacin, exercise should help to decrease the pain." The health care provider should be contacted immediately if the client develops any tendon pain, swelling, or inflammation because of the risk of tendon rupture. Exercise is contraindicated until tendon rupture is ruled out

A client with a urinary tract infection (UTI) is given a prescription for levofloxacin. The nurse should provide the client with which information about this medication?

"Pain in the back of the leg should be reported." Pain in the back of the leg could be indicative of tendonitis and therefore risk for tendon rupture.

Nitrofurantoin is prescribed for an adult client to treat acute urinary tract infection (UTI). Based on the normal adult dose, how should the nurse instruct the client to take this medication?

50 mg every 6 hours For treatment of acute UTI, the adult dosage is 50 mg every 6 hours.

The nurse has a prescription to administer bethanechol chloride subcutaneously. Before giving this medication, the nurse checks to ensure that which condition is not noted in the client's history?

Asthma Bethanechol chloride is a cholinergic medication that is used for urinary retention. This medication should not be used for clients with asthma because it can precipitate bronchoconstriction by activating muscarinic receptors. Other conditions this medication should not be used with include hypotension, bradycardia, gastric ulcers, intestinal obstruction, urinary tract obstruction, and hyperthyroidism.

Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L) Cyclosporine is an immunosuppressant. Nephrotoxicity can occur from the use of cyclosporine. The normal blood urea nitrogen level is 10 to 20 mg/dL. The normal creatinine level for a male is 0.6 to 1.2 mg/dL and for a female 0.5 to1.1 mg/dL

Laboratory analysis of a urine sample for culture and sensitivity reveals a bacterial infection, and the client is diagnosed with cystitis. Nitrofurantoin is prescribed for the client. Which is the priority nursing assessment before administering this medication?

Checking lung sounds Nitrofurantoin is an antibacterial used to treat urinary tract infections. Although rare, the medication can cause an asthmatic exacerbation in those with a history of asthma. Therefore, the priority baseline assessment should include questioning the client about a history of asthma and checking lung sounds.

The nurse receives a call from a client concerned about eliminating brown-colored urine after taking nitrofurantoin for a urinary tract infection. The nurse should make which appropriate response?

Continue taking the medication; the brown urine occurs and is not harmful." Nitrofurantoin imparts a harmless brown color to the urine and the medication should not be discontinued until the prescribed dose is completed

A client is prescribed dutasteride. Which outcome indicates that the medication is effective?

Decreased obstruction to outflow of urine through the urethra

The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list?

Drink 8 to 10 glasses of water per day. Each dose of trimethoprim-sulfamethoxazole should be administered with a full glass of water, and the client should maintain a high fluid intake to avoid crystalluria.

The nurse is reviewing the laboratory results for a client receiving tacrolimus. Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication?

Fasting blood glucose of 200 mg/dL (11.1 mmol/L) A fasting blood glucose level of 200 mg/dL (11.1 mmol/L) is significantly elevated above the normal range of 70 to 110 mg/dL (4 to 6 mmol/L) and suggests an adverse effect.

Propantheline bromide is prescribed for a client with bladder spasms. Which disorder, if noted in the client's record, should alert the nurse to question the prescription for this medication?

Glaucoma Propantheline bromide is contraindicated in clients with narrow-angle glaucoma, obstructive uropathy, gastrointestinal disease, or ulcerative colitis.

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Hematocrit of 33% (0.33) Epoetin alfa is synthetic erythropoietin, which the kidneys produce to stimulate red blood cell production in the bone marrow. The normal hematocrit level is Male:42% to 52% Female: 37% to 47% Therapeutic effect is seen when the hematocrit reaches between 30% and 33%

Phenazopyridine

However, clients may be treated for urinary tract pain with phenazopyridine, which is a urinary analgesic

The ambulatory care nurse is providing instructions to a client with a urinary tract infection (UTI) being started on nitrofurantoin. The nurse should provide the client with which information?

If taken with meals, it will help decrease the risk for gastrointestinal (GI) upset.

A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action?

Infusing slowly over 60 minutes A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation.

Nitrofurantoin

Nitrofurantoin can induce 2 kinds of pulmonary reactions: acute and subacute. Acute reactions, which are most common, manifest with dyspnea, chest pain, chills, fever, cough, and alveolar infiltrates. These symptoms resolve 2 to 4 days after discontinuing the medication. Subacute reactions are rare and occur during prolonged treatment. Symptoms (e.g., dyspnea, cough, malaise) usually regress over weeks to months following nitrofurantoin withdrawal. However, in some clients, permanent lung damage may occur.

Trimethoprim-sulfamethoxazole is prescribed to be administered by intravenous infusion to a client with a recurrent urinary tract infection. How should the nurse administer this medication?

Over 60 to 90 minutes but should not be mixed with any other medications or solutions. Trimethoprim-sulfamethoxazole is infused over 60 to 90 minutes

A client is receiving oxybutynin. The nurse should suspect that this medication is prescribed to relieve which condition?

Overactive bladder

A client who has had a prostatectomy is complaining of pain from bladder spasms. The nurse checks the health care provider's prescription sheet and expects to see which medication prescribed to treat the problem?

Oxybutynin Bladder spasms after prostatectomy are treated with antispasmodic medications, such as oxybutynin

A client with acute pyelonephritis who was started on antibiotic therapy 24 hours earlier is still complaining of burning with urination. The nurse should anticipate that the health care provider will prescribe which medication?

Phenazopyridine

A client is prescribed sulfamethoxazole for treatment of urinary tract infection. Identification of which other medication noted on the client's medical record requires further collaboration with the health care provider (HCP)?

Phenytoin Sulfonamides can intensify the effects of warfarin, phenytoin, and sulfonylurea-type oral hypoglycemics (e.g., glipizide, glyburide)

Nitrofurantoin is prescribed for the client. The nurse checks the client's record, knowing that this medication is contraindicated in which disorder?

Renal disease

A client taking metronidazole telephones the home health nurse to report dark discoloration to the urine. The nurse interprets that the client's complaint warrants which nursing action at this time?

Tell the client that this is a harmless medication side effect. Harmless darkening of the urine may occur, and the client should be told of this effect.

Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which interpretation about the client's complaints?

The client is experiencing a pulmonary reaction requiring cessation of the medication.

Tamsulosin hydrochloride has been prescribed for a client with benign prostatic hypertrophy (BPH). How should the nurse instruct the client to take the medication?

Thirty minutes after a meal

Oral bethanechol chloride is prescribed for the client. The nurse should instruct the client to take this medication at which time?

Two hours after meals Administration of bethanechol chloride with food can cause nausea and vomiting.

Tamsulosin hydrochloride is prescribed for a client. The nurse should suspect that this medication is prescribed to relieve which condition?

Urinary obstruction

Bethanechol chloride

is a cholinergic agent used to treat neurogenic bladder or urinary retention.

Probenecid

is a medication used for clients with gout to inhibit the reabsorption of uric acid by the kidneys and promote excretion of uric acid in the urine. Clients are instructed to modify their diets to limit excessive purine intake. High-purine foods to avoid or limit include organ meats, roe, sardines, scallops, anchovies, broth, mincemeat, herring, shrimp, mackerel, gravy, yeast, wine, and alcohol.

Bethanechol chloride is prescribed for an adult client with postoperative bladder spasms. Based on the normal adult dose, how should the nurse plan to administer this medication?

10 to 50 mg 3 to 4 times a day The normal adult dosage of bethanechol chloride ranges from 10 to 50 mg given 3 to 4 times daily.

The nurse is preparing a subcutaneous dose of bethanechol prescribed for a client with urinary retention. Before giving the dose, the nurse checks to see that which medication is available on the emergency cart for use if needed?

Atropine sulfate Bethanechol is a cholinergic medication. Administration of bethanechol could result in cholinergic overdose. The antidote is atropine (an anticholinergic)

A client being admitted to the nursing unit has been taking bethanechol chloride at home. During the admission assessment, the nurse gives special attention to assessing the client for which side and adverse effect of this medication?

Bradycardia

The nurse, who is administering bethanechol chloride, is monitoring for cholinergic overdose associated with the medication. The nurse should check the client for which sign of overdose?

Bradycardia Cholinergic overdose of bethanechol chloride produces manifestations of salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse should monitor the client for hypokalemia as a side effect of therapy if the client has been receiving which medication?

Bumetanide Bumetanide is a loop diuretic that places the client at risk for hypokalemia

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication?

Decongestants In the client with benign prostatic hyperplasia, episodes of urinary retention can be triggered by certain medications, such as decongestants, anticholinergics, and antidepressants

The nurse is taking care of a client receiving oxybutynin. Which finding should the nurse expect to note if the client develops side or adverse effects of this medication?

Dry mouth

The nurse is providing dietary instructions to a client who has been prescribed cyclosporine. Which food item should the nurse instruct the client to exclude from the diet?

Grapefruit juice grapefruit juice can raise cyclosporine levels by 50% to 100%, thereby greatly increasing the risk of toxicity.

A client with chronic kidney disease (CKD) who is receiving an antihypertensive medication is experiencing frequent hypotensive episodes. The nurse reviews the client's medication record, knowing that which medication would have the greatest tendency to cause hypotension?

Methyldopa

Ciprofloxacin is prescribed for a client with a Pseudomonas aeruginosa infection of the urinary tract. The health care provider (HCP) should be questioned by the nurse about the prescription if which underlying condition is noted in the client's record?

Myasthenia gravis Ciprofloxacin and other fluorquinolones can exacerbate muscle weakness in clients with myasthenia gravis. Accordingly, clients with a history of myasthenia gravis should not receive these medications.

The nurse is planning to administer furosemide 40 mg by intravenous push (IVP) through an existing intravenous (IV) line. To deliver this medication safely, the nurse should perform which action?

Pinch the IV tubing above the injection port, and inject slowly over 1 to 2 minutes. To administer medication by IVP, the IV tubing must be pinched above the injection port so that the medication does not go back up the tubing during injection. Most IVP medications should be injected slowly.

A client is receiving levofloxacin for treatment of urinary tract infection. Which finding warrants an immediate call to the health care provider (HCP)?

Prolonged QT interval on electrocardiogram Levofloxacin can prolong the client's QT interval, which would be noted on electrocardiogram. This warrants a call to the HCP because a prolongation in the QT interval can lead to torsades de pointes, a lethal dysrhythmia

Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would indicate a possible toxic effect related to this medication?

Restlessness Toxicity (overdosage) of oxybutynin produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability.

The home health nurse is caring for a client who is taking probenecid. The client has been instructed to restrict the diet to low-purine foods. Which food item should the nurse instruct the client to avoid?

Scallops Clients are instructed to modify their diets to limit excessive purine intake. High-purine foods to avoid or limit include organ meats, roe, sardines, scallops, anchovies, broth, mincemeat, herring, shrimp, mackerel, gravy, yeast, wine, and alcohol.

Parenteral bethanechol chloride is prescribed for a client with urinary retention. The nurse should plan to administer this medication by which route?

Subcutaneously The injectable form of bethanechol chloride is intended for subcutaneous administration only.

A client is prescribed trimethoprim-sulfamethoxazole for a recurrent urinary tract infection (UTI). The nurse should give the client which instruction regarding this medication?

Take each dose with 8 oz (235 mL) of water, and drink extra water each day.

Tacrolimus is prescribed for a client who underwent a kidney transplant. Which instruction should the nurse include when teaching the client about this medication?

Take the oral medication every 12 hours at the same times every day. It is important that the medication be taken at 12-hour intervals to maintain a stable blood level to prevent organ rejection.

Nitrofurantoin is prescribed for a client with urinary tract infection. The nurse is instructing the client regarding the administration of the medication. Which information about the besttime to take this medication should be included in the client's education?

With meals

Aluminum hydroxide is prescribed for a client with chronic kidney disease (CKD). The nurse should instruct the client to take this medication at what time?

With meals The client who is receiving aluminum hydroxide should take the medication with meals. The phosphate-binding effect of this medication is most effective when it is taken with food.

Oxybutynin chloride

antispasmodic that is used to treat bladder spasm

Propantheline bromide

antispasmodic that is used to treat bladder spasm