Nokea
A client develops a cough and fever and laboratory test results reveal leukopenia after the client receives sulfonamide therapy. When developing the client's plan of care, the nurse would identify which nursing diagnosis?
- A. Impaired Urinary Elimination
- B. Impaired Skin Integrity
- C. Risk for Secondary Infection
- D. Deficient Knowledge
Correct Answer: C
Rationale: Fever and leukopenia suggest an infection, which can occur secondarily with sulfonamide therapy. Therefore, Risk for Infection would be the most appropriate nursing diagnosis. Impaired Urinary Elimination would be appropriate if the client was experiencing changes in urinary output. Impaired Skin Integrity would be appropriate if the client developed a rash or hypersensitivity reaction. Deficient Knowledge would be appropriate if the client lacked understanding of the drug therapy, which is not evident in this situation.
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A client is being discharged with a prescription for sulfasalazine. Which of the following would the nurse include in the discharge teaching plan? Select all that apply.
- A. Take the drug 1 hour before or 2 hours after meals.
- B. Use protective sunscreen or cover exposed areas when going outside.
- C. Finish the entire course of sulfonamide even if you begin feeling better.
- D. Decrease fluid intake to prevent increased excretion of the drug.
- E. Keep all follow-up appointments
Correct Answer: B,C,E
Rationale: The nurse should teach the client to take sulfasalazine with food or immediately after a meal, to use sunscreen or cover exposed areas to prevent severe sunburn, to increase fluid intake to prevent renal calculi, to finish the entire course of drug even if the symptoms go away, and to keep all follow-up appointments.
The nurse is preparing to administer a prescribed sulfonamide. Which of the following would the nurse do? Select all that apply.
- A. Have the client sit up to take the drug
- B. Give the prescribed drug on an empty stomach
- C. Be sure to administer the drug immediately after a meal
- D. Have the client decrease his fluid intake
- E. Encourage the client to drink additional fluids
Correct Answer: A,B,E
Rationale: Oral medication should be administered to clients only when they are in an upright or sitting position. Sulfonamides should be administered on an empty stomach if tolerated with 8 ounces of water. Increased fluid intake is encouraged to prevent crystalluria.
After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was successful when the students identify which of the following as an example of a sulfonamide antibiotic? Select all that apply.
- A. Amoxicillin (Amoxil)
- B. Ciprofloxacin (Cipro)
- C. Sulfamethoxazole/trimethoprim (Bactrim)
- D. Clarithromycin (Biaxin)
- E. Silver sulfadiazine (Silvadene
Correct Answer: C,E
Rationale: Silver sulfadiazine(Silvadene) and sulfamethoxazole/trimethoprim(Bactrim) are sulfonamide antibiotics. Amoxicillin is an aminopenicillin. Ciprofloxacin is classified as a fluoroquinolone. Clarithromycin is a macrolide.
When reviewing the medical records of several clients who are prescribed sulfonamide therapy, the nurse would expect laboratory findings related to which bacteria? Select all that apply.
- A. Pseudomonas aeruginosa
- B. Escherichia coli
- C. Klebsiella pneumoniae
- D. Streptococcus pyogenes
- E. Staphylococcus aureus
Correct Answer: B,C,E
Rationale: Sulfonamides are often used to control infections caused by both gram-negative and gram-positive bacteria, such as Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Typically, sulfonamides are not used to treat infections caused by Pseudomonas aeruginosa or Streptococcus pyogenes.
Which of the following represent contraindications to treatment with a sulfonamide? Select all that apply.
- A. Children younger than 6 years of age
- B. Adults older than 65 years of age
- C. Lactating females
- D. Clients with group A beta-hemolytic streptococci infections
- E. Women in the second trimester of pregnancy
Correct Answer: C,D
Rationale: The sulfonamides are contraindicated in clients with hypersensitivity to the sulfonamides, during lactation, in children younger than 2 years of age, near the end of pregnancy, and for infections caused by group A beta-hemolytic streptococci.