CHAPTER 52 (DRUGS AFFECTING THE URINARY TRACT AND BLADDER)

The nurse is caring for an older adult. What is the primary nursing intervention to increase fluid intake in older adults?

Offer a variety of fluids to the client every hour.

A client is to receive methenamine. The nurse anticipates administering this drug by which route?

Oral

Which drug would the nurse identify as turning a client's urine reddish orange?

Phenazopyridine

A nurse is caring for a patient who is being administered phenazopyridine. The patient is distressed on seeing that the urine is exhibiting a reddish-orange discoloration. Which is the most appropriate response by the nurse?

"You don't have to worry. This is normal with this medication."

A client has been taking a urinary tract anti-infective for two days for treatment of a severe urinary tract infection. Today, the client calls the clinic reporting continued burning on urination. What is the nurse's best response?

"Burning on urination is a common side effect of these drugs. This may continue the entire time that you are on the medication."

A 56-year-old woman will soon begin treatment of her overactive bladder with tolterodine (Detrol). What patient teaching should the nurse provide to this woman?

"You might find that you get a dry mouth or a headache from this drug, but this does not mean it has to be discontinued."

The nurse is evaluating the effectiveness of flavoxate (Urispas). Which report by the patient indicates the drug has been effective?

"I slept uninterrupted through the night."

A nurse has educated a client about the drug phenazopyridine. Which client statement indicates clear understanding?

"My urine could be reddish orange."

A male client who takes dutasteride for benign prostatic hypertrophy calls the clinic. He says he tried to donate blood and was denied because of his medication. The client is very concerned about this and wants to know why this happened. What is the nurse's best response to the client?

"This medication can harm a developing fetus so your blood could be harmful if given to a pregnant woman."

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?

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

A patient in a health care facility has been prescribed trospium for the treatment of an overactive bladder. The physician has instructed the nurse to administer the drug 20 mg orally three times a day. The drug is available in 10 mg tablets. How many tablets will be administered to the patient with each dose?

2 tablets

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

A nurse is planning care for a client who is taking tolterodine. Which is an appropriate nursing diagnosis that is an indication for using this drug?

Altered Urinary Elimination related to overactive bladder

A nurse is developing a teaching plan for a client diagnosed with a UTI and prescribed nitrofurantoin. The nurse would prioritize which potential adverse reaction(s) to caution the client about? Select all that apply.

Anorexia Nausea Diarrhea

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?

Consume the medication with food.

A client with a urinary tract infection is encouraged to increase fluids. Which liquid will help acidify the urine?

Cranberry juice

A nurse is seeing a client who has been prescribed phenazopyridine in combination with an antibacterial medication to treat a urinary tract infection. What is important for the nurse to tell the client about this treatment?

Do not take this medication for more than two days

A nurse educating a client and their family about nitrofurantoin should advise the client that pulmonary reactions have been reported with the drug's use hours to three weeks after the drug therapy is initiated and to notify the health care provider if what occurs? (Select all that apply.)

Dyspnea Chest pain Cough Fever Chills

A nurse teaches a client and caregivers about nitrofurantoin which the client will continue to use at home. The nurse determines the session is successful when the client plans to notify the health care provider if which adverse reaction(s) occur? Select all that apply.

Dyspnea Chest pain Fever Chills

A patient using an oxybutynin patch must change the patch daily.

False

Which would lead a nurse to suspect that a client most likely has pyelonephritis?

Flank pain

A client is seeking treatment for bladder spasms causing dysuria and urgency. Which clinical condition identified in the client's medical history will serve to contraindicate treatment with a urinary tract antispasmodic medication?

Glaucoma

Which factors would predispose a female child to urinary tract infections? Select all that apply.

History of congenital bladder conditions Wiping back to front after using the toilet Evidence of recent sexual abuse

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 at least 2000 mL/day.

The nurse is aware that fosfomycin may be prescribed by the health care provider because of what feature that is unique among the urinary tract anti-infectives?

It is given one time only to treat urinary tract infections.

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.)

Methenamine (Hiprex) Nitrofurantoin (Macrodantin)

Which nursing observation is an appropriate outcome to indicate effective anti-infective therapy for a urinary tract infection?

Negative urinalysis

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?

No use of bubble bath liquids or salts

Which would be most important prior to beginning therapy with a urinary anti-infective agent?

Obtaining a urine culture and sensitivity test

For which disorder would treatment with an anti-infective be appropriate?

Pyelonephritis

The clinic nurse admitting a 39-year-old female who reports left-sided tenderness, fever, chills, and flank pain. What does the nurse suspect the patient has?

Pyelonephritis

Fosfomycin is an anti-infective that when administered orally is found in high concentrations in the urine, which makes it ideal for treating which infections? (Select all that apply.)

Pyelonephritis Prostatitis Cystitis

Which nursing diagnosis is highest priority for a patient with history of urinary urgency who is taking oxybutynin (Ditropan)?

Risk for impaired urinary elimination

A client who takes digoxin for heart failure is also prescribed trospium. The nurse would monitor the client closely for:

Signs of digoxin toxicity

The nurse is reviewing the medical record of a client who is to receive pentosan. What would alert the nurse to the need for close monitoring?

Splenic dysfunction

Which is an appropriate intervention for a side effect of a urinary antispasmodic medication?

Suck on ice or hard candy to treat dry mouth.

When considering the possible gastrointestinal side effects, what instruction should the nurse provide a client being prescribed a urinary tract antispasmodic?

Take medication with food

The nurse is caring for a client being treated for urosepsis. The client's medication regimen includes phenazopyridine. What outcome best indicates a therapeutic effect of this medication?

The client reports an absence of urinary burning and pain.

A client is experiencing signs and symptoms of an overactive bladder. Which agent would the nurse expect the health care provider to prescribe?

Tolterodine

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?

Urine culture and sensitivity

A female client is prescribed fosfomycin for a urinary tract infection (UTI). Which reported condition suggests an adverse effect of the medication?

Vaginal itching

A client diagnosed with a urinary tract infection (UTI) asks the nurse about how to prevent another infection. Which statement by the client indicates effective teaching by the nurse?

Wipe from front to back after going to the bathroom.

A nurse has administered nitrofurantoin to a client who is now reporting dyspnea and chest pain and is coughing. Which action should the nurse prioritize?

Withhold the drug and contact the primary health care provider.

When describing a urinary tract anti-infective, what would a nurse identify as one that acidifies the urine?

methenamine

The nurse should advise clients taking phenazopyridine that they may notice a change in urine color. Which color would the nurse identify?

orange

A client with a urinary tract infection (UTI) has a new prescription for nitrofurantoin. The nurse would question this order if the client has a history of:

renal dysfunction.