PHARM CH 18 PRACTICE Qs prepu
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 should withhold the medication and notify the health care provider when a client develops an adverse reaction. In this case, the client developed numerous mouth sores overnight so it must be addressed before proceeding with medication administration. The other responses do not state that the medication should be withheld.
A client who is taking phenazopyridine (Pyridium) for urinary analgesia along with nitrofurantoin calls the clinic to report that her sclera appears yellowish. What is the nurse's best response to this client?
"Phenazopyridine can cause your skin and your sclera to develop a yellowish discoloration." Explanation: Phenazopyridine may cause a yellowish discoloration of the skin or sclera. It is not related to the nitrofurantoin, does not indicate the development of hepatitis, and is not a res... (more) Phenazopyridine may cause a yellowish discoloration of the skin or sclera. It is not related to the nitrofurantoin, does not indicate the development of hepatitis, and is not a result of the urinary tract infection.
(see full question) 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 Explanation: The sulfonamides are used with caution in patients with renal impairment, hepatic impairment, or bronchial asthma. They are used to treat patients with ear infections, urinary trac... (more) The sulfonamides are used with caution in patients with renal impairment, hepatic impairment, or bronchial asthma. They are used to treat patients with ear infections, urinary tract infections, and ulcerative colitis. The topical sulfonamides are used to treat second- and third-degree burns
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? a) Gram negative b) Gram positive c) Both gram positive and gram negative d) Cross-fungal
Both gram positive and gram negative Explanation: The sulfonamides are used to treat both gram-negative and gram-positive bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella and Enterobacter species. They are ... (more) The sulfonamides are used to treat both gram-negative and gram-positive bacteria such as Escherichia coli, Staphylococcus aureus, and Klebsiella and Enterobacter species. They are not used to treat infections caused by fungus.
The nurse should advise patients taking phenazopyridine (Pyridium) that their urine may become discolored, which of the following colors? (Choose one) a) Brown b) Green c) Blue d) Purple
Brown Explanation: The nurse should advise patients taking phenazopyridine (Pyridium) that their urine may become discolored and may appear a dark orange to brown color.... (more) The nurse should advise patients taking phenazopyridine (Pyridium) that their urine may become discolored and may appear a dark orange to brown color.
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 Correct Explanation: The nurse should assess for a burning sensation or pain during application of mafenide. Skin turning yellow or urine taking on an orange hue is associated with sulfasalazine, not m... (more) The nurse should assess for a burning sensation or pain during application of mafenide. Skin turning yellow or urine taking on an orange hue is associated with sulfasalazine, not mafenide. The risk of Stevens-Johnson syndrome is present only for sulfonamides that are taken orally, not for topical sulfonamide preparations.
The nurse is aware that which hospitalized clients are most at risk for urinary tract infections? a) Clients with musculoskeletal disorders. b) Clients with indwelling urethral catheter. c) Clients with a central intravenous line. d) Clients with a cardiac disorder.
Clients with indwelling urethral catheter. Correct Explanation: UTIs may affect hospitalized clients and nursing home residents who have indwelling urethral catheters. Clients with musculoskeletal disorders, central intravenous lines or cardiac... (more) UTIs may affect hospitalized clients and nursing home residents who have indwelling urethral catheters. Clients with musculoskeletal disorders, central intravenous lines or cardiac disorders are not at an increased risk of urinary tract infections.
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 Correct Explanation: Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular-blocking drugs and increased profound respiratory de... (more) Interaction of antacids with a tetracycline drug causes decreased absorption of tetracycline. Increased action of neuromuscular-blocking drugs and increased profound respiratory depression are the result of interaction between neuromuscular-blocking drugs and tetracyclines. Increased risk of bleeding is a result of interaction between anticoagulants and tetracyclines.
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The patient was mistakenly administered tetracycline, which can cause adverse reactions. Which of the following could be a permanent effect in the child? a) Epigastric distress b) Abdominal pain or cramping c) Discoloration of the teeth d) Visual disturbances
Discoloration of the teeth Explanation: Tetracyclines cause permanent yellow-gray-brown discoloration of the teeth in children less than 9 years of age. Epigastric distress is not a permanent effect of the drug. Abdomina... (more) Tetracyclines cause permanent yellow-gray-brown discoloration of the teeth in children less than 9 years of age. Epigastric distress is not a permanent effect of the drug. Abdominal pain or cramping and visual disturbances are adverse reactions of macrolides.
Methenamine (Hiprex) should be used cautiously in patients with which of the following medical conditions? (Choose one) a) Osteoarthritis b) Rheumatoid arthritis c) Tendonitis d) Gout
Gout Explanation: Methenamine (Hiprex) should be used cautiously in patients with gout because it may cause crystals to form in the urine.... (more) Methenamine (Hiprex) should be used cautiously in patients with gout because it may cause crystals to form in the urine.
Which of the following nursing diagnoses would receive high priority for a burn patient on sulfonamide therapy? a) Risk for ineffective family coping b) Impaired skin integrity c) Risk for altered nutrition d) Risk for ineffective regimen management
Impaired skin integrity Correct Explanation: The skin can become more sensitive to sunlight during sulfonamide therapy. The nurse should inspect the patient's skin each shift for signs of sores or blisters, indicating a possi... (more) The skin can become more sensitive to sunlight during sulfonamide therapy. The nurse should inspect the patient's skin each shift for signs of sores or blisters, indicating a possible allergic reaction. Impaired skin integrity is the diagnosis of highest priority. Furthermore, a real diagnosis should always take priority over a risk for diagnosis.
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? a) Sulfonamide therapy is rendered ineffective b) Increased action of the anticoagulant c) Patient may develop leucopenia d) Increased risk of an anaphylactic shock
Increased action of the anticoagulant Correct Explanation: Taking sulfonamide drugs when the patient is already taking oral anticoagulants may result in increased action of the anticoagulants. Anaphylactic shock and leukopenia are some of ... (more) Taking sulfonamide drugs when the patient is already taking oral anticoagulants may result in increased action of the anticoagulants. Anaphylactic shock and leukopenia are some of the adverse reactions of sulfonamides, but are not associated with mixing sulfonamides and anticoagulants. Oral anticoagulants do not decrease the effectiveness of sulfonamides.
(see full question) 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 Correct Explanation: The nurse should instruct the patient to drink more fluids, so that the formation of crystals in urine (crystalluria) can be prevented. Unlike patients with thrombocytopenia, patie... (more) The nurse should instruct the patient to drink more fluids, so that the formation of crystals in urine (crystalluria) can be prevented. Unlike patients with thrombocytopenia, patients with crystalluria do not bruise easily so there is no need to exercise extra caution. Drinking cranberry juice is recommended for relieving symptoms of urinary tract infections, not for crystalluria. There is no need to shift the patient to a soft diet or a liquid diet.
A nurse is caring for an elderly patient with a UTI. Which of the following assessments should the nurse perform while caring for this patient? a) Assess the patient for bladder distension. b) Monitor the patient's vital signs every four hours. c) Document symptoms of the patient's condition. d) Document the patient's urine output every hour.
Monitor the patient's vital signs every four hours. Explanation: When caring for a patient with UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor vital signs of the patient every four hours after administration o... (more) When caring for a patient with UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor vital signs of the patient every four hours after administration of the drug or as ordered by the primary health care provider. Any significant rise in body temperature is reported to the primary health care provider because the methods of reducing the fever or culture and sensitivity tests may need to be repeated. The nurse should document the symptoms experienced by the patient and assess the patient for bladder distension as part of the pre-administration assessment before administering the drug to the patient. The nurse need not document the patient's urine output every hour or monitor the patient's respiratory rate in this case.
The pharmacology students are learning about medications used to treat urinary tract problems. What symptoms does phenazopyridine treat?
Pain and urgency Correct Explanation: Phenazopyridine is an azo dye that acts as a urinary analgesic and relieves symptoms of dysuria, burning, and frequency and urgency of urination. Phenazo does not treat urinary ret... (more) Phenazopyridine is an azo dye that acts as a urinary analgesic and relieves symptoms of dysuria, burning, and frequency and urgency of urination. Phenazo does not treat urinary retention, hematuria, or hesitancy.
A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for? a) Photosensitivity b) Cramping c) Abdominal pain d) Blood dyscrasias
Photosensitivity Explanation: Demeclocycline causes photosensitivity reactions. Abdominal pain and cramping are adverse reactions of macrolides. Blood dyscrasias is an adverse reaction of lincosamides.... (more) Demeclocycline causes photosensitivity reactions. Abdominal pain and cramping are adverse reactions of macrolides. Blood dyscrasias is an adverse reaction of lincosamides.
A clinic patient has been prescribed phenazopyridine (Pyridium) for aid in treating a UTI. This patient should be informed that Pyridium will change the urine to what color? a) Bluish-green b) Reddish-orange c) Brown d) Black
Reddish-orange Correct Explanation: Phenazopyridine turns urine orange-red, which may be mistaken for blood. Therefore Options A, C, and D are incorrect answers for this question.... (more) Phenazopyridine turns urine orange-red, which may be mistaken for blood. Therefore Options A, C, and D are incorrect answers for this question.
The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system? a) Hepatic b) Renal c) Neurological d) Integumentary
Renal Explanation: Sulfonamides should be administered with great caution in the older adult because of age-related, decreased renal function. Though hepatic function may diminish related to age, it ... (more) Sulfonamides should be administered with great caution in the older adult because of age-related, decreased renal function. Though hepatic function may diminish related to age, it is not a caution to sulfonamide therapy. The same is true for neurological and integumentary function.
Urinary tract anti-infectives act directly to destroy the bacteria or through acidification of the urine. a) False b) True
True
Which of the following is true in regards to the oral administration of tetracyclines? (Choose one) a) Tetracyclines should only be administered in the morning. b) Tetracyclines should be administered on a full stomach. c) Tetracyclines should be administered with a full glass of water. d) Tetracyclines should only be administered in the evening.
Tetracyclines should be administered with a full glass of water. Explanation: Tetracyclines should always be administered with a full glass of water and on an empty stomach (except minocycline and tigecycline may be taken with food).... (more) Tetracyclines should always be administered with a full glass of water and on an empty stomach (except minocycline and tigecycline may be taken with food).
Urinary anti-infectives are used only in urinary tract infections. What causes urinary anti-infectives to be so effective in treating UTIs?
They act specifically within the urinary tract Urinary tract anti-infectives act specifically within the urinary tract to destroy bacteria, either through a direct antibiotic effect or through acidification of the urine. They are not used in systemic infections because they do not attain therapeutic plasma levels. These drugs are not excreted through the liver, and they do not sterilize the feces.
A 32-year-old female patient has a urinary tract infection. Her record reveals that she has recently been treated for anemia. The physician has indicated that drug therapy for the urinary tract infection will last more than 2 weeks. The most important nursing action will be to a) measure the patient's blood pressure and heart rate. b) obtain a complete blood count to establish baseline values. c) determine whether the patient should be given medication orally or parenterally. d) measure the urine pH and check if it is acidic.
obtain a complete blood count to establish baseline values. Correct Explanation: The two most important tasks that are applicable to all therapies for UTIs are assessing whether the patient is hypersensitive to sulfonamides and taking a blood count before begin... (more) The two most important tasks that are applicable to all therapies for UTIs are assessing whether the patient is hypersensitive to sulfonamides and taking a blood count before beginning therapy to establish a baseline. The nurse could also measure the urine pH, but that is essentially an ongoing check. The nurse does not determine the method of administration; that is part of the drug order, as well as the dose. Measuring the blood pressure and heart rate is important and should be done, but it is not related to the UTI or drug therapy.
A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug a) with a meal. b) with milk or fruit juice. c) at bedtime only. d) on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs.
on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs. Explanation: Oral preparations of tetracycline should be administered on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not... (more) Oral preparations of tetracycline should be administered on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not absorbed effectively if taken with food or dairy products. The dosage must be distributed around the clock, and not just at bedtime, to increase effectiveness.
After teaching a patient who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the patient states which of the following? a) "I will take the drug with an antacid to prevent an upset stomach." b) "I should chew on gum and hard candies if my mouth gets sore." c) "I need to wear protective clothing when I'm out in the sun." d) "I should limit the amount of fluids that I drink."
"I need to wear protective clothing when I'm out in the sun." Correct Explanation: Photosensitivity is possible so the patient should use sunscreen and wear protective clothing when outdoors. Fluids should be increased to promote drug excretion. Ice chips or suga... (more) Photosensitivity is possible so the patient should use sunscreen and wear protective clothing when outdoors. Fluids should be increased to promote drug excretion. Ice chips or sugarless candy would be appropriate for combating a sore mouth. The drug should be taken on empty stomach 1 hour before or 2 hours after meals; antacids should not be taken with the drug because they can affect absorption.
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 Correct Explanation: Sulfonamides may cause the urine and skin to take on an orange-yellow color. Crystalluria may occur during administration of a sulfonamide. Often this problem can be prevented by i... (more) Sulfonamides may cause the urine and skin to take on an orange-yellow color. Crystalluria may occur during administration of a sulfonamide. Often this problem can be prevented by increasing fluid intake during treatmeent. It is important to instruct the patient to drink a full glass of water when taking an oral sulfonamide and to drink at least 8 large glasses of water each day until therapy is finished. Although drinking water will prevent dehydration, this is not a side effect of this type of drug therapy nor is fluid volume disturbance. There is also no proof that sulfonamides cause hypokalemia.
(see full question) The nurse is caring for a client who is receiving nitrofurantoin (Macrobid) for treatment of a urinary tract infection. Which symptoms of adverse reactions reported by the client would cause the nurse to contact the health care provider immediately? Select all that apply.
Dyspnea • Chest pain Correct Explanation: If an adverse reaction occurs such as photosensitivity, anorexia or diarrhea, the health care provider should be notified before the next dose is due. However, serious drug reactio... (more) If an adverse reaction occurs such as photosensitivity, anorexia or diarrhea, the health care provider should be notified before the next dose is due. However, serious drug reactions, such as pulmonary reactions (chest pain, dyspnea) are reported immediately.
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? a) Drink at least 8 to 10 full glasses of water every day. b) Failure to complete a course of therapy may result in a recurrence of the infection. c) Take the drug 1 hour before meals or 2 hours after meals. d) Take it with a full glass of water.
Failure to complete a course of therapy may result in a recurrence of the infection. Correct Explanation: When a sulfonamide is prescribed for an infection, some outpatients have a tendency to discontinue the drug once symptoms are gone. When teaching the patient the nurse emphasizes t... (more) When a sulfonamide is prescribed for an infection, some outpatients have a tendency to discontinue the drug once symptoms are gone. When teaching the patient the nurse emphasizes the importance of completing the prescribed course of therapy to ensure that all microorganisms causing the infection are erradicated. Failure to complete the course of therapy may result in a recurrence of the infection. The other options should be included in the teaching plan, but will not convince the patient to complete the full course of therapy
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? a) Notify the PHCP if abdominal pain occurs. b) Decrease fluid intake if symptoms subside. c) Discontinue the therapy if symptoms vanish. d) Increase fluid intake to at least 2000 ml/d.
Increase fluid intake to at least 2000 ml/d. Correct Explanation: The nurse should instruct the patient to increase the fluid intake to at least 2000 ml/d to help remove bacteria from the genitourinary tract when caring for a patient with a genito... (more) The nurse should instruct the patient to increase the fluid intake to at least 2000 ml/d to help remove bacteria from the genitourinary tract when caring for a patient with a genitourinary tract bacterial infection. The nurse need not instruct the patient to notify the PHCP if abdominal pain occurs, discontinue the therapy if symptoms vanish, or decrease fluid intake if symptoms subside. The nurse should stress the importance of continued therapy even if symptoms vanish or the patient feels better after a few doses. The nurse should encourage continued increased fluid intake even if the symptoms subside. Abdominal pain is not known in patients with genitourinary tract bacterial infections, and so the nurse need not educate the patient to monitor for the same.
The nurse informs a client of the most common adverse effect of sulfonamide therapy. What is it? a) Nausea b) Fever c) Photosensitivity d) Crystalluria
Nausea Explanation: Gastrointestinal effects (nausea, vomiting, anorexia, diarrhea, abdominal pain and stomatitis) are the most common adverse effects of sulfonamide therapy. Chills, fever, crystallur... (more) Gastrointestinal effects (nausea, vomiting, anorexia, diarrhea, abdominal pain and stomatitis) are the most common adverse effects of sulfonamide therapy. Chills, fever, crystalluria (crystals in the urine) and photosensitivity are also adverse effects but are not considered common.
A nurse is caring for a patient with irritation of the lower genitourinary tract. The patient is administered phenazopyridine. Which of the following conditions in patients contraindicates the use of the drug? a) Cerebral arteriosclerosis b) Diabetes c) Renal impairment d) Convulsive disorders
Renal impairment Explanation: Phenazopyridine, an anti-spasmodic drug, is contraindicated in patients with renal impairment and in undiagnosed urinary tract pain. The drug is not contraindicated in patients wit... (more) Phenazopyridine, an anti-spasmodic drug, is contraindicated in patients with renal impairment and in undiagnosed urinary tract pain. The drug is not contraindicated in patients with cerebral arteriosclerosis, convulsive disorders, or hepatic impairment. Nalidixic acid, which is an anti-infective drug, and nitrofurantoin are used cautiously in patients with cerebral arteriosclerosis, convulsive disorders, and diabetes.
You are caring for a patient who is taking a urinary anti-infectives. As a nurse, what would you need to assess this patient for? a) Signs and symptoms of continuing UTI b) Jaundice c) Discolored urine d) Flank pain
Signs and symptoms of continuing UTI Explanation: Monitor patient response to the drug (resolution of UTI and relief of signs and symptoms) and repeat culture and sensitivity tests as recommended for evaluation of the effectivenes... (more) Monitor patient response to the drug (resolution of UTI and relief of signs and symptoms) and repeat culture and sensitivity tests as recommended for evaluation of the effectiveness of all of these drugs. It would not be necessary to assess for discolored urine, jaundice, or flank pain.
You are speaking to a 62-year-old female patient who has been started on sulfisoxazole, a sulfonamide antibiotic. You should teach this patient to contact the physician if she experiences what adverse effect associated with the drug? a) Tachycardia b) Dizziness c) Polydipsia d) Skin rash or itching
Skin rash or itching Explanation: Patients taking sulfonamides should be instructed to contact the prescribing physician if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced al... (more) Patients taking sulfonamides should be instructed to contact the prescribing physician if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced allergic reaction and the need to change or stop the drug.
A 48-year-old female patient has acute pyelonephritis. Her urine pH is below 5.5, which indicates that it is acidic. Which of the following medications would serve to decrease the acidity of her urine?
Sodium bicarbonate Correct Explanation: Giving sodium bicarbonate to a patient who has acidic urine may help reduce its acidity. The nurse could also advise the patient to drink at least 1.5 L of water daily. Dihydrofoli... (more) Giving sodium bicarbonate to a patient who has acidic urine may help reduce its acidity. The nurse could also advise the patient to drink at least 1.5 L of water daily. Dihydrofolic acid, an agent that promotes the growth of new bacteria in the urinary tract, would not help alter the urine pH. Sulfonamide and gentamicin are drugs given to patients with urinary tract infections, and are not designed to alter the pH of urine.
You are the clinic nurse providing health teaching to a patient who has been prescribed doxycycline (Doxycin). You know that health teaching for this patient should include what instructions? a) Avoid sexual activity. b) Take an antacid with the drug if nausea occurs. c) Stay out of the sun. d) Chew the tablets completely before swallowing.
Stay out of the sun. Correct Explanation: Encourage the patient to apply sunscreen and wear clothing to protect exposed skin from skin rashes and sunburn associated with photosensitivity reactions. You would not teach the ... (more) Encourage the patient to apply sunscreen and wear clothing to protect exposed skin from skin rashes and sunburn associated with photosensitivity reactions. You would not teach the patient to avoid sexual activity, take an antacid, or chew tablets completely.
Mrs. Jones, age 35, has sought care because of complaints of urinary frequency, dysuria, and inability to empty her bladder completely, which she has experienced for the last 6 months. The physician diagnoses her with chronic urethritis and prescribes sulfonamide, which has led to crystalluria. Which medication can be added to her current medical therapy? a) Long-acting sulfonamide b) Methenamine c) Phenazopyridine d) Sulfisoxazole
Sulfisoxazole Explanation: Mrs. Jones can be given sulfisoxazole because it is a short-acting sulfonamide that is highly water-soluble, thus minimizing the risk for crystalluria. Long-acting sulfonamides are... (more) Mrs. Jones can be given sulfisoxazole because it is a short-acting sulfonamide that is highly water-soluble, thus minimizing the risk for crystalluria. Long-acting sulfonamides are not available for use in the United States because they can cause Stevens-Johnson syndrome. Methenamine is a urinary tract antiseptic that is indicated for suppressing or eliminating bacteriuria (bacteria in urine) associated with chronic cystitis and other chronic UTIs. Phenazopyridine is a UTI analgesic that is indicated for the symptomatic relief of pain, burning, frequency, and urgency caused by the irritation that infection produces in the urinary tract mucosa.
Which group of drugs should be avoided in children under the age of 8 years? a) Fluoroquinolones b) Cephalosporins c) Penicillins d) Tetracyclines
Tetracyclines Explanation: Tetracyclines can potentially damage developing teeth and bones and thus should be used cautiously or avoided in children under the age of 8 years.... (more) Tetracyclines can potentially damage developing teeth and bones and thus should be used cautiously or avoided in children under the age of 8 years.
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? a) The client is currently taking warfarin (Coumadin). b) The client doesn't like cranberry juice. c) The client had a hip replacement nine months ago. d) The client is allergic to tape.
The client is currently taking warfarin (Coumadin). Correct Explanation: It would be very important for the nurse to inform the health care provider that the client takes warfarin (Coumadin), which is an anticoagulant. Sulfadiazine will increase the act... (more) It would be very important for the nurse to inform the health care provider that the client takes warfarin (Coumadin), which is an anticoagulant. Sulfadiazine will increase the action of the anticoagulant and increase the chances of bleeding. The health care provider does not need immediate notification of any of the other choices.
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? a) Leukemia b) Hyperglycemia c) Leukopenia d) Thrombocytopenia
Thrombocytopenia Correct Explanation: Leukemia and hyperglycemia are not adverse effects of sulfonamide therapy. Leukopenia, although an adverse reaction, will cause signs of an infection such as fever, sore throat, an... (more) Leukemia and hyperglycemia are not adverse effects of sulfonamide therapy. Leukopenia, although an adverse reaction, will cause signs of an infection such as fever, sore throat, and cough. Thrombocytopenia is manifested by easy bruising and unusual bleeding after trauma to the skin or mucous membranes.
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? a) Wear protective eyewear. b) Avoid lights while indoors. c) Wear protective clothing and sunscreen when outside. d) Increase fluid intake.
Wear protective clothing and sunscreen when outside. Explanation: The nurse should encourage a patient to wear protective clothing while going out in the sun to reduce the effect of photosensitivity. While increasing the fluid intake is recommend... (more) The nurse should encourage a patient to wear protective clothing while going out in the sun to reduce the effect of photosensitivity. While increasing the fluid intake is recommended, it does not help combat the effects of photosensitivity. There is no need to avoid lights indoor; the skin becomes sensitive only to harsh sunlight during sulfonamide therapy. Wearing sunglasses may protect the eyes, but it will not protect the skin from the harmful effects of photosensitivity.
