Ch 20 Tetracyclines, Sulfonamides, & 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 need to fan the area while the wound is open." "I must avoid cleaning the wound before I apply the drug." "If I feel some stinging, I should call the health care provider." "I will apply it in a very thin layer over the area."

"I will apply it in a very thin layer over the area." Explanation: When applying a topical sulfonamide, the client should apply it in a thin layer, about 1/16-in thick. Some stinging on application is normal and need not be reported. Air drafts worsen the pain and should be avoided. The wound should be cleaned and any debris removed before the drug is applied.

The nurse is preparing to administer a sulfonamide to a client when the client states, "I woke up this morning with a lot of sores in my mouth." What is the nurse's next best action? "Take this dose of medication and I'll notify your health care provider." "You have most likely developed these sores due to the stress of the infection." "I wouldn't worry about it. It should get better in the next day or two." "I'm going to contact your health care provider before I administer your medication."

"I'm going to contact your health care provider before I administer your medication." Explanation: The nurse should withhold the medication and notify the health care provider when a client develops an adverse reaction. In this case, the client developed numerous mouth sores overnight so it must be addressed before proceeding with medication administration. The other responses do not state that the medication should be withheld.

A client who is taking phenazopyridine for urinary analgesia along with nitrofurantoin calls the clinic to report that her sclera appears yellowish. What is the nurse's best response to this client? "This is an expected side effect of this medication and is not alarming." "This is a result of the urinary tract infection and will go away once you have completed your anti-infective." "Come immediately to the clinic to be checked for hepatitis." "Stop taking the nitrofurantoin and the health care provider will prescribe another medication."

"This is an expected side effect of this medication and is not alarming." Explanation: Phenazopyridine may cause a yellowish discoloration of the skin or sclera. It is not related to the nitrofurantoin, does not indicate the development of hepatitis, and is not a result of the urinary tract infection.

The nurse knows that the normal recommended time to administer a sulfonamide to a client is at which time? at bedtime to decrease stomach upset 1 hour before or 2 hours after meals during meals with a large glass of water anytime with a sip of water

1 hour before or 2 hours after meals Explanation: Unless the order reads otherwise, the nurse knows the normal recommended time to give sulfonamides to the client whose stomach is empty; that is, 1 hour before meals or 2 hours after meals. If gastric irritation occurs, then the nurse would notify the health care provider, who would likely allow that it may be given with food or immediately after meals.

The nurse prepares to administer tetracycline 500 mg PO every 6 hours to an adult client newly diagnosed with Lyme's disease. The client takes an oral contraceptive for birth control. Which measures would the nurse provide for safe and effective drug administration? SELECT ALL THAT APPLY. A) Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). B) Administer the medication with milk or food to decrease gastrointestinal side effects. C) Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D) Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E) Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber.

A) Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). C) Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D) Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E) Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber.

A nurse reviewing a client's medication history notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? SELECT ALL THAT APPLY. A) Hydrochlorothiazide B) Metoprolol C) Acetaminophen D) Glipizide E) Furosemide

A) Hydrochlorothiazide D) Glipizide E) Furosemide

A nurse is teaching a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include? SELECT ALL THAT APPLY. A) Observe for bruising on the skin. B) Take the medication with milk or meals. C) Expect brown discoloration of urine. D) Crush the medication if it is difficult to swallow. E) Expect insomnia when taking it.

A) Observe for bruising on the skin. B) Take the medication with milk or meals. C) Expect brown discoloration of urine.

A nurse is teaching a client who has a severe UTI about ciprofloxacin. Which of the following information about adverse reactions should the nurse include? SELECT ALL THAT APPLY. A) Observe for pain and swelling of the Achilles tendon. B) Watch for a vaginal yeast infection. C) Expect excessive nighttime perspiration. D) Inspect the mouth for cottage-cheese like lesions. E) Take the medication with a dairy product.

A) Observe for pain and swelling of the Achilles tendon. B) Watch for a vaginal yeast infection. D) Inspect the mouth for cottage-cheese like lesions.

Phenazopyridine, a urinary antiseptic, turns urine what color? A) Reddish-orange B) Reddish- black C) Greenish-blue D) it has no effect on urine color

A) Reddish-orange

What is an appropriate nursing diagnoses for a patient taking a urinary anti-infective? A. Disturbed sensory perception (kinesthetic, tactile, visual) B. Incontinence C. Chronic pain D. Discolored urine

A. Disturbed sensory perception (kinesthetic, tactile, visual)

A patient is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What would contraindicate the use of Bactrim with this patient? A) Liver failure B) Rheumatoid arthritis C) Bone marrow depression D) Congestive heart failure

Ans: A Feedback: Hepatic disease contraindicates the use of Bactrim. The other listed health problems do not necessarily preclude the safe use of Bactrim.

A nurse is preparing to administer a patient's first scheduled dose of tetracycline. The nurse should first ensure that the patient has not recently eaten A) dairy products. B) leafy green vegetables. C) any high-fat foods. D) acidic foods.

Ans: A Feedback: It is important not to take tetracycline with dairy products, antacids, or iron supplements.

A patient is given tetracycline (Sumycin) to treat acne-related skin eruptions. How does tetracycline work? A) It binds to the 30S ribosome to inhibit protein synthesis. B) It reduces central nervous system stimulation. C) It is a beta-lactam antibiotic inhibiting cell wall synthesis. D) It works on the final stage of cell wall synthesis.

Ans: A Feedback: Tetracycline binds with the 30S ribosome to inhibit protein synthesis. It has no effect on the central nervous system. The penicillin agents are beta-lactam antibiotics. Ampicillin works in the final stage of cell wall synthesis.

A patient has been prescribed doxycycline (Vibramycin). Which of the following teaching instructions is a priority with this medication? A) Avoid sun exposure. B) Avoid unprotected sexual activity. C) Administer with an antacid. D) Chew the tablets.

Ans: A Feedback: The administration of doxycycline increases photosensitivity, which is a common side effect. Avoidance of sexual activity is not taught. The medication should not be administered with an antacid; the administration of an antacid will result in diminished absorption of the medication. The doxycycline tablets should not be chewed.

A patient is administered a sulfonamide for a urinary tract infection. Which of the following nursing interventions is most appropriate to increase the alkalinity of the patient's urine? A) Provide at least 2000 mL of water daily. B) Administer sodium bicarbonate. C) Recommend a tub bath every evening. D) Provide orange juice daily.

Ans: B Feedback: The urine can be alkalinized by giving sodium bicarbonate. The administration of water is important but will not increase alkalinity. The taking of tub baths is not recommended due to the fact that doing so increases the risk of urinary tract infection. The administration of orange juice increases acid, not alkalinity.

A patient has been prescribed phenazopyridine (Pyridium) for urinary tract symptoms related to the infection. The patient asks why she is taking this medication. What is the most appropriate response by the nurse? A) "This medicine is used to treat urinary retention." B) "This medicine will stop the blood in your urine." C) "This medicine will decrease the pain of your infection." D) "This medicine will prevent hesitancy when you're passing urine."

Ans: C Feedback: Phenazopyridine (Pyridium) is given to relieve pain associated with urinary tract infection. It is not administered for urinary retention, hematuria, or hesitancy.

A young adult patient's acne has responded well to treatment with tetracycline. However, the patient has now returned to the clinical with signs and symptoms of oral candidiasis. The nurse should recognize that this patient's current health problem is likely attributable to which of the following? A) A delayed (type IV) hypersensitivity reaction B) The fact that the patient may have chewed the capsules prior to swallowing them C) Superinfection following the eradication of normal oral flora D) A type I hypersensitivity reaction

Ans: C Feedback: Candidal superinfections may result from the use of tetracycline. The superinfection results from the elimination of normal flora and is not a hypersensitivity reaction. This is not the result of physical contact between the drug and the oral mucosa.

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? A) Assessing for the presence of asthma B) Assessing for hypertension C) Assessing for diabetes mellitus D) Assessing for renal insufficiency

Ans: D Feedback: Both tetracyclines and sulfonamides are contraindicated in patients with renal failure. These medications are not contraindicated in patients with asthma, hypertension, or diabetes mellitus.

A teenager asks the nurse how tetracycline (Sumycin) will improve her acne. Which of the following is the best statement the nurse can provide to the patient regarding the action of tetracycline? A) "Tetracycline decreases redness and swelling of the pustules." B) "Tetracycline treats the Chlamydia organism that causes acne." C) "Tetracycline is used in combination with doxycycline to treat acne." D) "Tetracycline interferes with the production of free fatty acids."

Ans: D Feedback: Tetracyclines interfere with the production of free fatty acids and decrease Corynebacterium in sebum. Tetracycline will decrease redness and swelling, but this response is not the direct action of the medication. Tetracycline treats Chlamydia but is not the cause of acne. Tetracycline is not combined with doxycycline.

A 64-year-old female patient sought care for the treatment of a urinary tract infection, and her primary care provider prescribed nitrofurantoin. What change in the patient's health status would prompt the use of an alternative medication? A) The patient develops a fluid volume deficit. B) Urinalysis reveals the presence of ketones. C) The patient develops leukocytosis. D) The patient's UTI progresses to urosepsis.

Ans: D Feedback: Urinary antiseptics may be bactericidal for sensitive organisms in the urinary tract because these drugs are concentrated in renal tubules and reach high levels in urine. They are not used in systemic infections because they do not attain therapeutic plasma levels. Consequently, the development of urosepsis would necessitate a systemic antibiotic. Fluid deficit, ketones in the urine, and elevated white cells would not necessarily contraindicate the use of nitrofurantoin.

A 9-year-old boy has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the boy's admission orders and notes that IV demeclocycline (Declomycin) has been ordered. After beginning this treatment, the nurse should confirm the results of what laboratory test? A) Mean corpuscular volume (MCV) B) D-dimer C) Bilirubin D) Blood urea nitrogen (BUN)

Ans: D Feedback: When administering demeclocycline, it is important to monitor the patient's BUN. Increases in the BUN are secondary to antianabolic effects. D-dimer and MCV values are not relevant. Bilirubin levels would only be important in the presence of liver toxicity.

A nurse is teaching a client about taking tetracycline to treat a GI infection due to H. pylori. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A) I will take this medication with 8 oz of milk. B) I will let my doctor know if I start having diarrhea. C) I can stop taking this medication when I feel completely well. D) I can take this medication just before bedtime.

B) I will let my doctor know if I start having diarrhea.

The nurse prepares to administer nitrofurantoin 100 mg PO every 12 hours to an adult client newly diagnosed with a urinary tract infection. Which measures would the nurse provide for safe and effective drug administration? SELECT ALL THAT APPLY. A) Instruct the client that the drug is a urinary analgesic to provide pain relief of urinary tract infection symptoms. B) Inform the client that the medication may cause the urine to turn a harmless brown coloration. C) Administer the drug with a meal or snack because food helps with drug absorption and decreases onset of GI distress. D) Administering with antacids with magnesium increase the drug absorption of the nitrofurantoin. E)Educate the client that the drug is safe with pregnancy and has no adverse effects on fetal development.

B) Inform the client that the medication may cause the urine to turn a harmless brown coloration. C) Administer the drug with a meal or snack because food helps with drug absorption and decreases onset of GI distress.

A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? A) Administer a concentrated solution. B) Infuse the medication over 60 minutes. C) Infuse the solution through the primary IV's tubing. D) Choose a small peripheral vein for administration.

B) Infuse the medication over 60 minutes.

Your client has a deep wound that is draining large amounts of purulent material. You know that which of the following antibiotics should NOT be ordered for this client? Bactrim Tetracycline Vibramycin Penicillin

Bactrim Explanation: Sulfonamides halt multiplication of new bacteria but do not kill mature, fully formed bacteria. With the exception of the topical sulfonamides used in burn therapy, the presence of pus, serum, or necrotic tissue interferes with sulfonamide action because these materials contain PABA.

The pharmacology instructor is teaching about sulfonamides and informs the students that these drugs are used to control infections caused by which bacteria? Fungal growths Both gram positive and gram negative Gram positive Gram negative

Both gram positive and gram negative Explanation: The sulfonamides are used to treat both gram-negative and gram-positive bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella and Enterobacter species. They are not used in the treatment of fungal infections.

The nurse is educating a client diagnosed with a urinary tract infection about the prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The client has a history of type 2 diabetes and currently takes a sulfonylurea. Which statement made by the client establishes the need for further clarification? A) "I will monitor my blood sugar carefully since the drug may lower it." B) "I will take the drug with 8 ounces of water before or after meals." C) "The drug will not affect the herbal supplement, ginseng that I take." D) "If a rash develops, the drug will be discontinued and my prescriber notified."

C) "The drug will not affect the herbal supplement, ginseng that I take."

Nitrofurantoin, a urinary antiseptic, turns urine what color? A) Red B) Green C) Brown D) Orange

C) Brown

A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim-sulfamethoxazole. Which of the following information should the nurse include? A) Take the medication even if pregnant. B) Maintain a fluid restriction while taking it. C) Take it on an empty stomach. D) Stop taking it when manifestations subside.

C) Take it on an empty stomach.

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? Avoid driving and performing tasks that require alertness. Call the prescriber for pain medication. Drink frequent sips of water. Consume the medication with food. Urine culture and sensitivity

Consume the medication with food. Explanation: The client is experiencing common adverse reactions related to the medication. Other adverse reactions include anorexia, nausea, vomiting, diarrhea, abdominal pain, or stomatitis. The client should be instructed to drink extra fluids and take the medication with food. Calling the prescriber for pain medication is not indicated. The client is not reporting an inability to stay alert.

The nurse is educating a client newly diagnosed with a urinary tract infection about the prescribed phenazopyridine hydrochloride. Which statement made by the client establishes the need for further clarification? A) "The drug is an azo dye that acts directly on urinary tract mucosa to provide pain relief." B) "If I develop a sore throat, bleeding, or bruising, I will report the symptoms to my prescriber." C) "I will need to take the drug with food to decrease stomach upset." D) "I should report reddish-orange urine immediately to the prescriber."

D) "I should report reddish-orange urine immediately to the prescriber."

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? Increased action of neuromuscular-blocking drugs Decreased absorption of tetracycline Increased profound respiratory depression Increased risk of bleeding

Decreased absorption of tetracycline Explanation: Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular-blocking drugs and increased profound respiratory depression are the result of interaction between neuromuscular-blocking drugs and tetracyclines. Increased risk of bleeding is a result of interaction between anticoagulants and tetracyclines.

Which nursing diagnoses would receive high priority for a burn client on sulfonamide therapy? Risk for body image alteration Impaired skin integrity Risk for ineffective regimen management Potential for altered nutrition

Impaired skin integrity Explanation: The skin can become more sensitive to sunlight during sulfonamide therapy. The nurse should inspect the client's skin each shift for signs of sores or blisters, indicating a possible allergic reaction. Risk for impaired skin integrity is the diagnosis of highest priority. Furthermore, a real diagnosis should always take priority over a risk for diagnosis or potential diagnosis.

The nurse learns that a 7-year-old child has been prescribed tetracyclines several times in recent years. What assessment should the nurse prioritize? Assess the client's deep tendon reflexes. Inspect the client's teeth. Inspect the client's skin and sclerae for jaundice. Assess the client for signs of ototoxicity.

Inspect the client's teeth. Explanation: Use tetracyclines with caution in children younger than 8 years of age because they can potentially damage developing bones and teeth. Tetracyclines are not closely linked to ototoxicity or hepatic damage. CNS effects such as decreased deep tendon reflexes are unlikely.

Your client tells you that she is taking an antibiotic and a pain medication for a urinary tract infection. She cannot recall the name of the pain medication. You suspect the name of her pain medication is: Vibramycin. Pyridium. Penicillin. Bactrim.

Pyridium. Explanation: Pyridium is given to relieve pain associated with UTI. It has no antibacterial activity.

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? Convulsive disorders Renal impairment Cerebral arteriosclerosis Diabetes

Renal impairment Explanation: Phenazopyridine, an anti-spasmodic drug, is contraindicated in clients with renal impairment and in undiagnosed urinary tract pain. The drug is not contraindicated in clients with cerebral arteriosclerosis, convulsive disorders, or hepatic impairment. Nalidixic acid, which is an anti-infective drug, and nitrofurantoin are used cautiously in clients with cerebral arteriosclerosis, convulsive disorders, and diabetes.

A client calls the clinic nurse and reports gastrointestinal upset after taking nitrofurantoin on an empty stomach. What recommendation should the nurse make? Taking the medicine with or after meals Taking vitamin C along with the medication Continuing to take the medicine on an empty stomach Stopping the medication

Taking the medicine with or after meals

Urinary anti-infectives are used only in urinary tract infections. What causes urinary anti-infectives to be so effective in treating UTIs? They act specifically within the urinary tract They sterilize the feces They are excreted through the liver They reach high plasma levels in a short period of time

They act specifically within the urinary tract Explanation: Urinary tract anti-infectives act specifically within the urinary tract to destroy bacteria, either through a direct antibiotic effect or through acidification of the urine. They are not used in systemic infections because they do not attain therapeutic plasma levels. These drugs are not excreted through the liver, and they do not sterilize the feces.

T/F: Tetracyclines are rarely used for systemic infections.

True

T/F Tetracyclines can be prescribed for the treatment of specific STD's

True for certain chlamydial infections, pelvic inflammatory disease, STD's

Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply. Ulcerative colitis Acute otitis media Urinary tract infection Upper respiratory tract infection Osteomyelitis

Ulcerative colitis Urinary tract infection Acute otitis media Explanation: Sulfonamides are often used to treat ulcerative colitis, urinary tract infection, and acute otitis media.

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 eyewear. Avoid lights while indoors. Increase fluid intake. Wear protective clothing and sunscreen when outside.

Wear protective clothing and sunscreen when outside. Explanation: The nurse should encourage a patient to wear protective clothing while going out in the sun to reduce the effect of photosensitivity. While increasing the fluid intake is recommended, it does not help combat the effects of photosensitivity. There is no need to avoid lights indoor; the skin becomes sensitive only to harsh sunlight during sulfonamide therapy. Wearing sunglasses may protect the eyes, but it will not protect the skin from the harmful effects of photosensitivity.

A nurse is caring for a patient receiving nitrofurantoin for acute bacterial UTI. The drug is known to cause acute pulmonary reactions such as dyspnea, chest pain, cough, fever, and chills. What interventions should the nurse perform if these reactions are observed in the patient? Withhold the drug and contact primary health care provider. Provide oxygen support to the patient. Offer fluids to the patient at regular intervals. Monitor patient for a tightness of the chest.

Withhold the drug and contact primary health care provider. Explanation: The nurse should immediately notify the primary health care provider and withhold the next dose of the drug until the patient is seen by a primary health care provider if acute pulmonary reactions are observed in the patient. The nurse should monitor the patient for signs of a nonproductive cough or malaise, which may indicate a chronic pulmonary reaction, which may occur during prolonged therapy. Tightness of the chest is not known to occur in case of a chronic pulmonary reaction, and so the nurse need not monitor the patient for the same. The nurse offers fluids at regular intervals to elderly patients who develop decreased thirst sensation as an adverse reaction to the urinary tract anti-infectives.

Sulfonamides are classified as which type of medication? antiviral antifungal antiprotozoal antibacterial

antibacterial Explanation: Sulfonamides treat bacterial infections and are considered antibacterial drugs. Antifungals are used to combat fungal infections such as yeast. Antivirals are used to combat viral infections such as the flu. Antiprotozoals combat microscopic organisms called protozoans that can inhabit water and food supplies.

A nurse is caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for: discolored urine. jaundice. signs and symptoms of continuing UTI. flank pain.

signs and symptoms of continuing UTI.

A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed? tetracycline amoxicillin tetracycline hydrochloride phenazopyridine hydrochloride

tetracycline

The nurse is caring for a client with ulcerative colitis who is taking sulfasalazine. What instruction will the nurse give this client? "Expect burning during urination." "Expect to be constipated." "Expect your urine to turn yellow-orange." "Expect to have insomnia."

"Expect your urine to turn yellow-orange."

The nurse would recommend that a client who is taking sulfisoxazole should have fluid intake of how many liters of fluid? 3 L 2 L 4 L 1 L

2L

A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day? 8 6 4 2

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 65-year-old woman admitted with a urinary tract infection and history of chronic renal failure A 26-year-old man with an ear infection and a history of bronchial asthma A 35-year-old woman with a urinary tract infection and a history of ulcerative colitis A 48-year-old man with pneumonia and a history of liver disease

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

The client admitted to the hospital is ordered sulfasalazine 500 mg QID. The drug comes from the pharmacy in 1000-mg capsules. What is the best action by the nurse? Administer 1 capsule twice a day Administer 1/2 capsule Contact the pharmacist Contact the health care provider

Contact the pharmacist

The tetracyclines are effective against a wide range of which type of organisms? Gram-negative organisms Beta-lactamase-positive organisms Gram-positive and gram-negative organisms Gram-positive organisms

Gram-positive and gram-negative organisms

A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which can be an adverse effect of the drug? Yellow-gray-brown discoloration of the teeth Bacterial overgrowth of nonsusceptible organisms Increase in the blood pressure Toxic effects to the developing fetus

Toxic effects to the developing fetus

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? orange coloration of urine Stevens-Johnson syndrome burning sensation during application skin turning yellow

burning sensation during application Explanation:The nurse should assess for a burning sensation or pain during application of mafenide. Skin turning yellow or urine taking on an orange hue is associated with sulfasalazine, not mafenide. The risk of Stevens-Johnson syndrome is present only for sulfonamides that are taken orally, not for topical sulfonamide preparations.

A client with a UTI also has a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency. Based on the nurse's understanding of urinary drugs, the nurse would expect to administer which drug with caution if prescribed? ciprofloxacin nitrofurantoin amoxicillin methenamine

nitrofurantoin

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: measure the urine pH and check if it is acidic. measure the client's blood pressure and heart rate. obtain a complete blood count to establish baseline values. determine whether the client should be given medication orally or parenterally.

obtain a complete blood count to establish baseline values. Explanation:The two most important tasks that are applicable to all therapies for UTIs are assessing whether the client is hypersensitive to sulfonamides and taking a blood count before beginning therapy to establish a baseline. The nurse could also measure the urine pH, but that is essentially an ongoing check. The nurse does not determine the method of administration; that is part of the drug order, as well as the dose. Measuring the blood pressure and heart rate is important and should be done, but it is not related to the UTI or drug therapy.

A client cannot recall the name of the medication prescribed to help manage the pain associated with a urinary tract infection (UTI). What medication was likely prescribed? doxycycline minocycline hydrochloride phenazopyridine hydrochloride trimethoprim-sulfamethoxazole

phenazopyridine hydrochloride

Sulfasalazine (Azulfidine) is contraindicated in people who are allergic to: nonopioid analgesics. salicylates. NSAIDs. diuretics.

salicylates.

The health care provider has ordered phenazopyridine to a client with a urinary tract infection as a urinary analgesic. The client has also been prescribed an anti-infective. The client may use the phenazopyridine for what duration? one day Entire course of treatment with anti-infective 12 hours two days

two days

A nurse is monitoring a client on sulfonamide therapy. Which finding would lead the nurse to suspect that the client is developing thrombocytopenia? fever cough unusual bleeding sore throat

unusual bleeding Explanation: A person with thrombocytopenia shows visible signs of easy bruising and unusual bleeding after moderate to slight trauma to the skin. Fever, cough, and sore throat are common symptoms associated with many other conditions; they do not specifically indicate thrombocytopenia.

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? 24-hour urine quantity oral temperature urine culture and sensitivity results assessment for dysuria or flank pain

urine culture and sensitivity results

A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug? losartan vancomycin atorvastatin warfarin

warfarin

The nurse is caring for a client with a nursing diagnosis of "Impaired urinary elimination related to discomfort of urinary tract infection." Which medication will provide comfort to this client? Fosfomycin Phenazopyridine Nitrofurantoin Sulfamethoxazole

Phenazopyridine

A 44-year-old woman has presented to her local clinic with burning and pain when voiding. In addition to prescribing an antibiotic, the clinician has recommended the use of phenazopyridine (Pyridium). What is the rationale for including phenazopyridine in this client's plan of care? Phenazopyridine increases the pH of the urine. Phenazopyridine dilates the urethra, allowing for more complete bladder emptying and relief from frequency. Phenazopyridine potentiates the effects of many antibiotics that are used in the treatment of UTIs. Phenazopyridine provides topical relief to many of the painful symptoms of UTIs.

Phenazopyridine provides topical relief to many of the painful symptoms of UTIs.

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for? Cramping Abdominal pain Blood dyscrasias Photosensitivity

Photosensitivity

The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent says they doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask? "Have they ever received tetracycline?" "Have they ever received gentamicin?" "Have they ever received ampicillin?" "Have they ever received cephalexin?"

"Have they ever received tetracycline?"

Which statement by a client taking a sulfonamide requires further instruction? "I will take all of my medicine even if my symptoms go away." "I will be sure to drink a full glass of water every time I take my medicine." "I will make sure to use extra sunscreen when I go to the tanning booth." "I will take my medicine with my meals like it says on the prescription bottle."

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

The nurse is providing care to an 84-year-old client who is receiving nitrofurantoin for a urinary tract infection. The client has recently developed an infection to a venous ulcer on the lower leg. The nurse's colleague tells the nurse, "The nitrofurantoin should likely help with the client's leg ulcer as well as the UTI." What is the nurse's best response? "Nitrofurantoin doesn't have any systemic effects, so the client will need another antibiotic." "That would only be effective if the client were changed from oral to intravenous delivery." "There's no way of knowing until we get the wound culture and sensitivity results." "Nitrofurantoin isn't used in high enough doses to affect nongenitourinary infections."

"Nitrofurantoin doesn't have any systemic effects, so the client will need another antibiotic."

A client has been prescribed tetracycline for the treatment of acne. How would the nurse explain the action of the drug? "Tetracycline reduces the number of bacteria in the blood running through your skin." "Tetracycline interferes with the growth of the bacteria causing the pimples." "Tetracycline interferes with components of bacterial protein synthesis." "Tetracycline changes the chemical structure of your skin so it's less hospitable to bacteria."

"Tetracycline interferes with the growth of the bacteria causing the pimples."

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? "Decrease your water intake until you have finished your medication." "You probably have developed an urinary tract infection due to the medication." "I'll consult with your provider about reducing the dosage of sulfasalazine." "This is a normal reaction that will cease when the therapy is finished."

"This is a normal reaction that will cease when the therapy is finished."

What is the nurse's best response when the client who has a confirmed urinary tract infection asks why the nurse is obtaining a urine sample for culture and sensitivity? "The test is needed to know that you are adequately hydrated." "This test lets the health care provider know what medication will best treat the infection." "This test tells the health care provider if the infection has traveled to your kidneys." "This test is done to make sure that you are not pregnant."

"This test lets the health care provider know what medication will best treat the infection."

Which laboratory value should the nurse assess in patients who are receiving demeclocycline? A. blood urea nitrogen B. aspartate aminotransferase C. alanine aminotransferase D. creatinine

A. blood urea nitrogen When administering demeclocycline, it is important to monitor the client's blood urea nitrogen (BUN). Increases in the BUN are secondary to antianabolic effects.

A woman develops a urinary tract infection following the delivery of an infant. The nurse practitioner is considering prescribing trimethoprim-sulfamethoxazole. What assessment is necessary to make? A. if the woman is breast-feeding B. if the woman has been treated with the medication in the past C. if anyone in her family has a known allergy to the drug D. if she is experiencing hematuria

A. if the woman is breast-feeding It is important to assess if the woman is breast-feeding. If a fetus or young infant receives a sulfonamide by placental transfer, in breast milk, or by direct administration, the drug displaces bilirubin from binding sites on albumin. As a result, bilirubin may accumulate in the bloodstream (hyperbilirubinemia) and central nervous system (kernicterus), causing life-threatening toxicity.

Which of the following foods should not be taken with tetracycline? A. orange juice with calcium B. cranberry juice cocktail C. tomato juice D. lemonade

A. orange juice with calcium Tetracycline is contraindicated with calcium or dairy products.

A man has had a urinary tract infection, and a prescriber orders phenazopyridine. Which of the following adverse effects should he report immediately to his health care provider? (Select all that apply.) A. yellowing of the skin B. edema C. bruising D. malaise E. sore throat F. fever

A. yellowing of the skin C. bruising E. sore throat F. fever Yellowing of the skin indicates an accumulation of phenazopyridine. In addition, bruising, sore throat, and fever indicate an accumulation of phenazopyridine.

A 70-year-old woman is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which of the following is a sulfonamide that will most likely be prescribed? A) Trimethoprim-sulfamethoxazole (Bactrim) B) Tetracycline (Sumycin) C) Doxycycline (Vibramycin) D) Demeclocycline (Declomycin)

Ans: A Feedback: Trimethoprim-sulfamethoxazole is used to treat chronic bronchitis due to pneumococci. Tetracycline, doxycycline, and demeclocycline are not sulfonamides

A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a patient who is diagnosed with what STI? A) Vaginitis B) Chlamydia C) Human papillomavirus D) Trichomoniasis

Ans: B Feedback: Tetracycline is effective for treating Mycoplasma, Chlamydia, and Rickettsia. It is not efficacious in the treatment of trichomoniasis, HPV, or vaginitis.

A patient is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for Lyme's disease? A) Ibuprofen (Motrin) B) Tetracycline (Sumycin) C) Phenazopyridine (Pyridium) D) Nitrofurantoin (Macrodantin)

Ans: B Feedback: Tetracyclines are useful in treating some animal bites and Lyme's disease. Ibuprofen is administered for the inflammation associated with the arthritic pain, but not to treat the infection. Phenazopyridine is not administered for Lyme's disease. Nitrofurantoin is administered for urinary tract infections.

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? A) Intrathecal B) Topical C) Parenteral D) Oral

Ans: B Feedback: Topical sulfonamides are used in prevention of burn wound infections. Sulfonamides are not administered intrathecally. Parenteral and oral administrations are not recommended for the prevention of a burn infection.

A group of students are reviewing the contraindications for the use of urinary tract antispasmodics. The students demonstrate the need for additional review when they identify what as a contraindication? Obstructive uropathy Myasthenia gravis Anticoagulant therapy Glaucoma

Anticoagulant therapy

A man is receiving treatment for a Mycoplasma pneumoniae infection. He says that drinking orange juice hurts his mouth. What priority assessment should the nurse make? A. Assess the patient's fecal output for signs and symptoms of diarrhea. B. Assess the patient's mouth for signs of candidal infection. C. Assess the patient's lung sounds for rales or rhonchi. D. Assess the patient's intake and output.

B. Assess the patient's mouth for signs of candidal infection. When a client reports mouth pain and difficulty swallowing when taking an anti-infective agent such as tetracycline, it is necessary to inspect the client's mouth for white patchy areas. These areas indicate Candida albicans, a superinfection of the mouth.

A physician has ordered trimethoprim-sulfamethoxazole (TMP-SMZ) for a woman with a urinary tract infection. The nurse has asked the patient about whether she takes any over- the-counter medications. The patient reports that she regularly takes St. John's wort as a mood elevator. Which of the following patient teaching interventions is most important? A. Taking St. John's wort and TMP-SMZ results in no known interactions. B. TMP-SMZ combined with St. John's wort leads to an increased therapeutic effect of the TMP-SMZ. C. TMP-SMZ has a decreased effect when given with St. John's wort. D. When given in combination, TMP-SMZ and St. John's wort result in manic tendencies.

B. TMP-SMZ combined with St. John's wort leads to an increased therapeutic effect of the TMP-SMZ. When taken concurrently with sulfisoxazole, St. John's wort enhances the efects of the sulfisoxazole.

A nurse is applying silver sulfadiazine (Silvadene) to a child's burns. Which of the following nursing interventions is most important when applying the medication? A. providing pain medication B. using sterile gloves C. giving the child a bath D. teaching the parent to apply the medication

B. using sterile gloves When applying silver sulfadiazine to a burned area, it is important to wear sterile gloves.

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. Bactericidal medications improve the destruction of bacteria. Bactericidal medications preserve bacteria growth. Bacteriostatic medications destroy bacteria.

Bacteriostatic medications slow or retard the multiplication of bacteria.

Your client is 84 years old. She has been diagnosed with a UTI. As part of her discharge instructions, you would include which of the following instructions? Because you are taking tetracycline, you will need to use other contraceptives. Because you are taking tetracycline, you will need to return in 5 days for a urine test to check kidney function. Because you are taking tetracycline, you will need to brush your teeth twice a day to prevent discoloration. Because you are taking tetracycline, you will need to increase your fluids to 2 liters or more per day to prevent renal crystals.

Because you are taking tetracycline, you will need to increase your fluids to 2 liters or more per day to prevent renal crystals.

A physician has ordered intravenous sulfamethoxazole with trimethoprim. How should the nurse administer the medication? A. in 500 mL of 0.45% normal saline B. in 150 mL of 10% dextrose and water C. in 125 mL of 5% dextrose and water D. in 125 mL of 5% dextrose and 0.45% normal saline

C. in 125 mL of 5% dextrose and water When administering sulfamethoxazole and trimethoprim intravenously, it is necessary to dilute the medication in 125 mL of 5% dextrose and water.

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 Teenagers Children younger than 2 months School-aged children

Clients with a hypersensitivity to sulfonamides Women who are lactating Children younger than 2 months Explanation:Studies have shown that sulfonamides are contraindicated for use in clients with a hypersensitivity to sulfonamides, during lactation, and in children younger than 2 months. No research shows that school-aged children and teenagers should not take sulfonamides.

A nurse practitioner has prescribed nitrofurantoin for a woman with a urinary tract infection. Which of the following cardiovascular adverse effects is this patient at risk for developing? A. inverted T wave B. widened QRS C. premature ventricular contraction (PVC) D. bundle branch block

D. bundle branch block Bundle-branch block and changes in the ST and T waves are cardiac-related adverse efects of nitrofurantoin.

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? Dehydration Crystalluria Anuria Proteinuria

Crystalluria

In the event of a bioterrorism attack with anthrax, you would anticipate the use of which drug? Bactrim Doxycycline Pyridium Penicillin A patient is admitted to the emergency department following opening an envelope containing a substance that experts have identified as anthrax. Which of the following medications is likely to be A. tetracycline B. doxycycline C. amoxicillin-clavulanic acid combination D. neomycin

Doxycycline Clients who are asymptomatic receive doxycycline or ciprofloxacin for 60 days following exposure to anthrax.

The nurse is caring for a neonate of a mother who took a sulfonamide during the last weeks of pregnancy. For which condition will the nurse monitor the neonate? Select all that apply. Hypothermia Rash Hemolytic anemia Jaundice Thrombocytopenia

Hemolytic anemia Jaundice

If a fetus or young infant receives a sulfonamide by placental transfer, in breast milk, or by direct administration, the drug displaces bilirubin from binding sites on albumin. As a result, what may the fetus experience? Select all that apply Hyperkalemia Kernicterus Hyperbilirubinemia Hypernatremia

Hyperbilirubinemia Kernicterus

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 Hyperglycemia Increased bruising Elevated temperature

Hypoglycemia

The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action? Inflammation is decreased because of interaction with intestinal bacteria. It causes intestinal bacteria to replicate and repopulate. All intestinal bacteria are destroyed by the medication. Bacteria causing ulcerative colitis are killed off.

Inflammation is decreased because of interaction with intestinal bacteria. *Sulfonamides are bacteriostatic, which means they inhibit the growth of bacteria but do not destroy or kill off bacteria. They are used to treat ulcerative colitis because they interact with intestinal bacteria and help inhibit the inflammatory process.*

A nurse is caring for a client with crystalluria. When caring for the client, which intervention would the nurse include in the plan of care to prevent more stones from forming? When administering a sulfonamide, which of the following interventions is most effective in decreasing crystalluria? Instruct the client to increase fluid intake to 2000 mL. Ensure care while moving client to avoid bruising. Change the client's diet to a soft diet or a liquid diet. Instruct client to drink cranberry juice regularly.

Instruct the client to increase fluid intake to 1500-2000 mL. To prevent crystalluria, it is essential that clients receive 2000 mL of fuids in a 24-hour period.

A female client is diagnosed with hepatitis C as well as a urinary tract infection. The organism is sensitive to tetracycline. Why is the health care provider reluctant to order tetracycline in a client with hepatic impairment? It increases drug elimination. It slows drug elimination. It eliminates absorption of the medication. It causes intermittent drug elimination.

It slows drug elimination.

A client has been admitted for treatment of a burn on the left arm. Which sulfonamides are most likely to be prescribed to treat this condition? Select all that apply. Trimethoprim (TMP) and sulfamethoxazole (SMZ) (Bactrim) Mafenide (Sulfamylon) Silver sulfadiazine (Silvadene) Sulfisoxazole (Azo -Gantrisin) Sulfasalazine (Azulfidine)

Mafenide (Sulfamylon) Silver sulfadiazine (Silvadene)

A daily urine pH level may be ordered by the health care provider for clients taking which anti-infectives for a UTI as they work better in acidic urine? (Select all that apply.) Amoxicillin (Amoxil) Fosfomycin (Monurol) Nitrofurantoin (Macrodantin) Nalidixic (NegGram) Methenamine (Hiprex)

Methenamine (Hiprex) Nitrofurantoin (Macrodantin)

A 3-year-old has a history of recurrent urinary tract infections (UTI). Which practice implemented by the parents for the child indicates an understanding of preventive measures regarding these infections? 3 ounces of orange juice daily No use of bubble bath liquids or salts Provides acrylic underwear Cleans the perineal area from back to front

No use of bubble bath liquids or salts Explanation:Cystitis is very difficult to treat in young girls and can become a chronic problem. To decrease the number of bacteria introduced into the bladder, patient education should cover the following hygiene measures: Always wipe from front to back and never from back to front to avoid the introduction of intestinal bacteria into the urethra; avoid baths, particularly bubble baths, which facilitate the entry of bacteria into the urethra on the bubbles; and wear dry cotton underwear to discourage bacterial growth. Patient education also should stress the importance of avoiding alkaline ash foods (e.g., citrus fruits, certain vegetables) and antacids and encouraging foods that acidify the urine.

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? Provide client with eight ounces of fluid. Obtain urine for culture and sensitivity. Administer acetaminophen for temperature. Administer sulfasalazine (Azulfidine).

Obtain urine for culture and sensitivity. Explanation: A culture and sensitivity is obtained to determine which bacteria is growing in the urine, and which antibiotic the bacteria is sensitive to. It must be performed prior to any antibiotic being given to the client so that the test will be accurate. Most acetaminophen orders are for elevated temperature at or above 101.

A nurse has been instructed to administer mafenide to a patient. Which of the following adverse reactions should the nurse assess for in this patient? Rash, itching, or other allergic reactions Loss of appetite Inflammation of the mouth Crystals in the urine sample

Rash, itching, or other allergic reactions

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

Renal Explanation:Sulfonamides should be administered with great caution in the older adult because of age-related, decreased renal function. Though hepatic function may diminish related to age, it is not a caution to sulfonamide therapy. The same is true for pancreatic and splenic function.

Urinary antiseptics may be bactericidal for sensitive organisms in the urinary tract because these drugs are concentrated in what structure? Renal calculi Nephrons Bladder Renal tubules

Renal tubules

A client who takes digoxin for heart failure is also prescribed trospium. The nurse would monitor the client closely for: Changes in urine color Increased central nervous system effects Excess anticholinergic effects Signs of digoxin toxicity

Signs of digoxin toxicity Explanation:Trospium interacts with digoxin, leading to increased serum levels of digoxin. Therefore, the nurse would need to monitor the client for signs and symptoms of digoxin toxicity. Levels of trospium would not increase, so increased central nervous system effects or excess anticholinergic effects would most likely not occur. The combination of trospium and digoxin does not change the color of urine.

A 48-year-old female patient has acute pyelonephritis. Her urine pH is below 5.5, which indicates that it is acidic. Which of the following medications would serve to decrease the acidity of her urine? A sulfonamide Sodium bicarbonate Dihydrofolic acid Gentamicin

Sodium bicarbonate *Giving sodium bicarbonate to a patient who has acidic urine may help reduce its acidity. The nurse could also advise the patient to drink at least 1.5 L of water daily. Dihydrofolic acid, an agent that promotes the growth of new bacteria in the urinary tract, would not help alter the urine pH. Sulfonamide and gentamicin are drugs given to patients with urinary tract infections, and are not designed to alter the pH of urine.*

A male client presents to the emergency department in pain. He is diagnosed with mild to moderate burns on his forearms secondary to exposure to hot pipes in his home. The nurse expects the health care provider to order what topical medication? Tetracycline Amoxicillin Penicillin Sulfadiazine

Sulfadiazine *Sulfonamides are rarely used in critical care settings, except that topical silver sulfadiazine (Silvadene) is used to treat burn wounds.*

The nurse is counseling a client who has been prescribed nitrofurantoin for treatment of a urinary tract infection. What should the nurse teach the client specific to timing of this medication? Take it immediately before going to bed. Take it with food or milk. Take it two hours after meals. Take it one hour before meals.

Take it with food or milk.

When considering the possible gastrointestinal side effects, what instruction should the nurse provide a client being prescribed a urinary tract antispasmodic? Suck on sugarless hard candy after taking medication Take medication with food Minimize the amount of dairy within 2 hours of taking the medication Take medication with full glass of water

Take medication with food

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? Take the drug along with milk or fruit juice. Take the drug immediately after meals. Take the drug along with a meal. Take the drug on an empty stomach.

Take the drug on an empty stomach. Explanation:Oral preparations of tetracycline should be administered on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not absorbed effectively if taken with food or dairy products. The dosage must be distributed around the clock, and not just at bedtime, to increase effectiveness.

The nurse is providing discharge teaching to a client who is being sent home on oral tetracycline. What instructions should the nurse include? Take the medication only once a day. Hold the drug if pulse is below 60 beats per minute (bpm). Take the drug on an empty stomach. Take the medication with two ounces of water.

Take the drug on an empty stomach. Explanation:Oral preparations of tetracycline should be administered on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not absorbed effectively if taken with food or dairy products. The dosage must be distributed around the clock, and not just at bedtime, to increase effectiveness.

A client who has been diagnosed with syphilis reports an allergy to penicillin. The nurse would anticipate that which drug will be prescribed for the treatment? Phenazopyridine hydrochloride Amoxicillin Trimethoprim-sulfamethoxazole Tetracycline

Tetracycline Explanation:Tetracycline may be effective in treating syphilis when penicillin cannot be given. If the client is allergic to penicillin, it is likely they are also allergic to amoxicillin. Trimethoprim-sulfamethoxazole is prescribed to treat urinary tract infections (UTIs), while phenazopyridine hydrochloride is used to manage the pain associated with UTIs.

Which of the following are true of tetracyclines? Select all that apply. Tetracyclines are broad spectrum antibiotics. Tetracyclines may cause permanent discoloration of the teeth in children. Tetracyclines can be used when penicillins are contraindicated. Tetracyclines are contraindicated in children younger than 16 years. Tetracyclines are used to treat Rocky Mountain spotted fever.

Tetracyclines are broad spectrum antibiotics. Tetracyclines may cause permanent discoloration of the teeth in children. Tetracyclines can be used when penicillins are contraindicated. Tetracyclines are used to treat Rocky Mountain spotted fever.

Which statement is true in regards to the oral administration of tetracyclines? Tetracyclines should be administered with a full glass of water. Tetracyclines should be administered on a full stomach. Tetracyclines should only be administered in the evening. Tetracyclines should only be administered in the morning.

Tetracyclines should be administered with a full glass of water. Explanation:Tetracyclines should always be administered with a full glass of water and on an empty stomach (except minocycline and tigecycline may be taken with food).

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 allergic to cephalosporins. The client doesn't like cranberry juice. The client is currently taking warfarin (Coumadin). The client had a hip replacement less than six months ago.

The client is currently taking warfarin (Coumadin). Explanation:It would be very important for the nurse to inform the health care provider that the client takes warfarin (Coumadin), which is an anticoagulant. Sulfadiazine will increase the action of the anticoagulant and increase the chances of bleeding. The health care provider does not need immediate notification of any of the other choices.

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 has two consecutive urine cultures that are negative The client's urine remains free of blood The client reports an absence of urinary burning and pain The client's urine output is ≥ 1250 mL/24 hours

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? Hypotension Hypokalemia Hyperglycemia Thrombocytopenia

Thrombocytopenia Explanation:Leukopenia, hypokalemia and hyperglycemia are not adverse effects of sulfonamide therapy. Thrombocytopenia is a complication manifested by easy bruising and unusual bleeding after trauma to the skin or mucous membranes.

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? Sulfadiazine Sulfasalazine Sulfisoxazole Trimethoprim (TMP) and sulfamethoxazole (SMZ)

Trimethoprim (TMP) and sulfamethoxazole (SMZ)

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? Liver function panel Renal function panel Urine culture and sensitivity Complete blood count (CBC)

Urine culture and sensitivity

The action of sulfonamides is classified as which type of medication? bactericidal bacteriostationary bacteriophage bacteriostatic

bacteriostatic

The nurse is reviewing recent laboratory values for an older client prior to administration of tetracycline. Which finding would lead the nurse to hold the dose? creatinine of 2.8 mg/dL (247.52 µmol/L) (high) leukocyte count of 11.6/mm3 (high) hemoglobin of 10.5 g/dL (105.00 g/L) (low) potassium of 3.4 mEq/L (3.40 mmol/L) (low)

creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection? white blood cell count x-ray culture and sensitivity (C&S) tissue biopsy

culture and sensitivity (C&S) C&S testing helps to identify the best drug for eradicating the bacterial infection. The white blood cell count will indicate the presence of infection but not what drug to treat it with. A tissue biopsy will determine a tissue type. An x-ray will only give visual views of structures in the body.

A client is prescribed phenazopyridine. In addition to informing the client that the drug can cause a change in urine color, the nurse would tell the client that which may also change color? facial color nail beds tooth enamel fluid lubricating the eyes

fluid lubricating the eyes

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 vitamin D calories proteins

fluids

A nurse administers methenamine cautiously to a client with a history of which condition? rheumatoid arthritis osteoarthritis gout tendonitis

gout *Methenamine should be used cautiously in clients with gout because it may cause crystals to form in the urine.*

A night nurse administered a PRN dose of aluminum hydroxide with magnesium hydroxide to a client at 06:40. What action should the dayshift nurse take when preparing to administer the client's scheduled 08:00 dose of oral tetracycline? contact the health care provider to obtain a prescription for an alternative antibiotic administer the tetracycline as prescribed skip the 08:00 dose of tetracycline and resume treatment with the next scheduled dose hold the tetracycline until 08:40

hold the tetracycline until 08:40

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

penicillins Explanation:Prescribers order tetracycline when penicillin is contraindicated to treat infections caused by Klebsiella, Neisseria gonorrhoeae, Treponema pallidum, Listeria monocytogenes, Clostridium, Bacillus anthracis, Fusobacterium fusiforme, and Actinomyces.

The nurse should expect to see which effect when warfarin is administered concomitantly to a client who is prescribed sulfamethoxazole? decreased anti-infective effect increased anti-infective effect increased anticoagulant effect decreased anticoagulant effect

increased anticoagulant effect

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description? inhibiting bacterial cell wall synthesis inhibiting bacterial DNA gyrase depolarizing the bacterial cell wall inhibiting bacterial protein synthesis

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 inhibition of DNA-gyrase disruption of bacterial cell wall synthesis inhibition of bacterial RNA-dependent protein synthesis

inhibition of the activity of folic acid in bacterial cell metabolism

A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how? on an empty stomach. take with a meal. with milk or fruit juice. at bedtime only.

on an empty stomach.

The nurse is administering a urinary tract drug that exerts a topical analgesic effect on the lining of the urinary tract. Which drug would the nurse be most likely to administer? amoxicillin phenazopyridine trimethoprim methenamine

phenazopyridine

A nurse is caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for: jaundice. discolored urine. signs and symptoms of continuing UTI. flank pain.

signs and symptoms of continuing UTI.

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 health care provider if the client experiences what adverse effect associated with the drug? skin rash or itching tachycardia dizziness polydipsia

skin rash or itching Explanation:Clients taking sulfonamides should be instructed to contact the prescriber if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced allergic reaction and the need to change or stop the drug.

The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age? Kidneys Vision Hearing Teeth What is the rationale for not administering tetracycline (Sumycin) to children under theage of 8 years? A) It will not treat the infection. B) It will increase the risk of heart failure. C) It will interfere with enamel development. D) It will increase the risk for future infections.

teeth C) It will interfere with enamel development. Feedback:Tetracyclines should not be used in children younger than 8 years because of theireffects on teeth and bones. In teeth, the drugs interfere with enamel development. Themedication can treat the infection. Tetracycline does not increase the risk of heartfailure. The administration of tetracycline will not increase the risk of future infections.

When discussing the use of phenazopyridine the nurse will tell the patient that the drug carries a high risk of photosensitivity. the drug is available only by prescription. she must come to the outpatient clinic each day for intravenous administration. the drug relieves burning during urination

the drug relieves burning during urination