Pharm Ch 20

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."

The nurse is admitting a 12-year-old child to the acute care facility and notices discolored secondary teeth. The parent says they don'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?"

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 client who is taking phenazopyridine and nitrofurantoin for treatment of a urinary tract infection calls the clinic to report a yellowish discoloration of the skin. What is the nurse's best response to this client?

"I will let the health care provider know immediately."

A client is scheduled for abdominal surgery and is ordered to receive neomycin. The client asks the nurse why this drug is prescribed. Which response by the nurse would be most appropriate?

"The drug helps eliminate bacteria so that your GI tract is as clean as possible for surgery."

The nurse is providing education to a client who has been prescribed trimethoprim-sulfamethoxazole. What statement would the nurse include about potential adverse effects?

"This drug might make your stomach a bit upset, so let me know if you experience that."

Sulfonamides are often used to treat UTI in children older than what age?

2 months

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 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 nurse in an ambulatory care setting routinely conducts a nursing assessment as part of the care. Which assessments are most important for the nurse to complete in clients presenting with an active infection? Select all that apply.

Client's use of self-remedies Review of lab results Vital signs Client's symptoms Client's general appearance

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 is receiving statin therapy as treatment for elevated lipid levels is also prescribed daptomycin. The nurse would assess which of the following laboratory test results for changes?

Creatine phosphokinase levels

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?

Decreased absorption of tetracycline

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?

Hyperbilirubinemia Kernicterus

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 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 has returned to the clinic for follow-up of an infection which is being treated with an aminoglycoside and reports ringing in the ears and dizziness. When developing this client's plan of care, which nursing diagnosis would be the priority?

Injury Risk

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.

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 slows drug elimination.

A group of students are reviewing the agents used as urinary tract anti-infectives. The students demonstrate understanding of the material when they cite which as an example?

Nitrofurantoin

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

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.

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

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

Phenazopyridine

The nurse is preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect?

Prolonged clotting times

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

Renal

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

Renal tubules

The clinic nurse is providing health teaching to a client who has been prescribed doxycycline. What is a priority teaching point for this client?

Stay out of the sun as much as possible.

After administering sulfonamides to a client, the nurse observes the client has developed a fever, cough, and muscular aches, as well as lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which possible adverse reaction?

Stevens-Johnson syndrome (SJS)

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

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

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.

The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?

Teeth

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

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 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.

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 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 client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?

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 likely 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 caring for a client who is taking a urinary anti-infectives. The nurse would need to assess this client for:

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

A client with a deep wound producing large amounts of purulent drainage is prescribed an antibiotic. The nurse should express concern about the potential effectiveness of the treatment if which medication is prescribed?

trimethoprim-sulfamethoxazole

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