PN119 PrepU Chapter 6
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 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?
"I'm going to contact your health care provider before I administer your medication."
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 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 degree to which input resources are physically changed by the conversion is referred to as the
1/2 tablet
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 would question the use of sulfonamide therapy in which client? (Select all that apply.)
18-month-old female client breastfeeding client 32 years of age
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 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
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
What are sulfonamides classified as?
Antibacterial
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? (Choose one)
Bacterial resistance
Drugs that destroy the bacteria are known as which of the following? (Choose one)
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
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
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
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
The nurse is teaching the patient who has just been placed on sulfasalazine about its potential adverse reactions. One reaction the nurse should definitely include in teaching is which of the following?
May cause the skin and urine to turn orange-yellow
The nurse is caring for a client who is on sulfonamide therapy and monitors the client for which common side effects? (Select all that apply.)
Nausea Diarrhea Photosensitivity
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 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 Women who are lactating Children younger than 2 months
The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?
Renal
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 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 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
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.
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
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
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 nursing student is learning about sulfonamides in pharmacology class. The student correctly identifies some of the gastrointestinal system's adverse reactions to this class of drugs by listing which of the following? (Select all that apply.)
Nausea Vomiting Anorexia Stomatitis
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).
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
A 74-year-old man with a history of prostatitis has been prescribed SMZ-TMP for the treatment of a urinary tract infection. Which of the following teaching points should the nurse include in patient education?
"If you can, try to take your pill on an empty stomach."
A professional female cyclist has been prescribed SMZ-TMP for chronic urethritis. She has informed the nurse that she has a cross-country race in 2 days. Which of the following would be an appropriate response by the nurse?
"It would not be a good idea to be outside while taking this medication because of possible photosensitivity occurring."
The nurse is caring for a client who takes hydantoin (Dilantin) every day to prevent seizures. The health care provider has ordered a sulfonamide to treat a urinary tract infection. What does the nurse expect to occur in relation to these drugs?
A change from the sulfonamide to another antibiotic
The nurse is caring for a client on sulfonamide who has developed a fever, cough, and headache. What signs/symptoms would alert the nurse to the possible development of Stevens-Johnson syndrome? Select all that apply.
Blister on the lip Red wheal on the neck
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 body is equipped with a natural defense system that includes which of the following? (Select all that apply)
Saliva Tears Skin Sweat Mucous
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 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 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.
Drugs that slow or retard the multiplication of bacteria are known 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