Ch 20: Drug Therapy w/ Tetraclycines, 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 will apply it in a very thin layer over the area."

A teenager asks the nurse how tetracycline will improve her acne. Which of the following is the best statement the nurse can provide to the patient regarding the action of tetracycline?

"Tetracycline interferes with the production of free fatty acids."

A client asks the nurse about drinking cranberry juice to prevent UTIs. The nurse informs the client that it is safe to use, suggesting an intake of which amount daily?

4-8 ounces

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

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?

Administer sodium bicarbonate.

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?

Assessing for renal insufficiency

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

Both gram positive and gram negative

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?

Chlamydia

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 Children younger than 2 months

A client who routinely takes antacids has been prescribed tetracycline. The nurse explains to the client that there is an increased risk of which effect related to this combination?

Decreased absorption of tetracycline

A nurse is preparing a teaching session for a client prescribed an antibacterial for a UTI. Which instruction should the nurse point out in the teaching session?

INCREASE FLUID INTAKE TO ATLEAST 2000 ML/DAY

The health care professional has recommended sulfonamide therapy for a patient. While obtaining the patient's medical history, the nurse discovers that the patient is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants?

Increased action of the anticoagulant

A client develops a cough and fever and laboratory test results reveal leukopenia after receiving sulfonamide therapy. When developing the client's plan of care, the nurse would determine which nursing diagnosis is most appropriate?

Infection (Secondary) Risk

A patient is given tetracycline to treat acne-related skin eruptions. How does tetracycline work?

It binds to the 30S ribosome to inhibit protein synthesis

What is the rationale for not administering tetracycline to children under the age of 8 years?

It will interfere with enamel development.

A patient is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What would contraindicate the use of Bactrim with this patient?

Liver failure

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?

Obtain urine for culture and sensitivity.

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

Renal

A 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?

Superinfection following the eradication of normal oral flora

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 on an empty stomach. Take the drug along with a meal. Take the drug along with milk or fruit juice. Take the drug immediately after meals.

Take the drug on an empty stomach.

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?

The patient's UTI progresses to urosepsis

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?

Trimethoprim-sulfamethoxazole

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?

Warfarin

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 clothing and sunscreen when outside.

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

dairy products.

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:

obtain a complete blood count to establish baseline values.

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

Tetracyclines should not be used in children younger than 8 years of age because of their effects on:

teeth and bones.

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

tetracycline

The nurse is caring for a client who is taking a urinary anti-infective. Which assessment should the nurse prioritize to identify the effectiveness of the client's drug treatment?

urine culture and sensitivity results