Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics (pharm)

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

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?

Crystalluria

Which nursing diagnoses would receive high priority for a burn client on sulfonamide therapy?

Impaired skin integrity

A nurse is educating a patient undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the patient as part of the patient teaching plan?

Increase fluid intake to at least 2000 ml/d.

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 patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline?

Increased risk of bleeding

The nurse learns that a 7-year-old child has been prescribed tetracyclines several times in recent years. What assessment should the nurse prioritize?

Inspect the client's teeth.

he 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.

Robert Shue, age 62, is an athletic, tall man. He suffers from dysuria and frequency. He has been diagnosed with a urinary tract infection. He has been prescribed an antibiotic and urinary analgesic. Today he contacts the office reporting that his urine color has changed to orange. What drug was most likely prescribed to him?

Phenazopyridine

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

Renal

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?

Renal impairment

Which of the following is an example of a sulfonamide antibiotic? Select all that apply.

Silver sulfadiazine (Silvadene) Sulfamethoxazole/Trimethoprim (Bactrim)

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?

Sulfadiazine

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 drug on an empty stomach.

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?

Tetracycline

Which statement is true in regards to the oral administration of tetracyclines?

Tetracyclines should be administered with a full glass of water.

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 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?

Thrombocytopenia

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)

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 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.

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?

burning sensation during application

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)

A nurse administers methenamine cautiously to a client with a history of which condition?

gout

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?

hold the tetracycline until 08:40

The nurse is assessing a client who has been prescribed tetracycline for possible contraindications to therapy. The nurse understands that what risks are posed by tetracycline therapy during pregnancy? Select all that apply.

hyperbilirubinemia impaired tooth development impaired bone development

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description?

inhibiting bacterial protein synthesis

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?

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:

obtain a complete blood count to establish baseline values.

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?

phenazopyridine

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?

phenazopyridine hydrochloride

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

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

tetracycline

When discussing the use of phenazopyridine the nurse will tell the patient that

the drug relieves burning during urination

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?

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?

warfarin

The nurse is caring for a client with ulcerative colitis who is taking sulfasalazine. What instruction will the nurse give this client?

"Expect your urine to turn yellow-orange."

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 knows that the normal recommended time to administer a sulfonamide to a client is at which time?

1 hour before or 2 hours after meals

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

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.

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

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

Bruises