Nokea
A client who is on sulfonamide therapy is about to be discharged. Which of the following precautions should the nurse instruct the client to follow to reduce the effects of photosensitivity?
- A. Wear protective clothing and sunscreen when outside.
- B. Increase fluid intake.
- C. Avoid lights while indoors.
- D. Wear protective footwear
Correct Answer: A
Rationale: The nurse should encourage a client 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 while indoors; the skin becomes sensitive only to harsh sunlight during sulfonamide therapy. Wearing protective footwear may protect the feet from injury, but it will not protect the skin from the harmful effects of photosensitivity.
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The nurse is providing care to a client with diabetes who is receiving sulfonamides. The nurse counsels the client about the increased risk of hypoglycemia, especially if the client is taking which of the following medications? Select all that apply.
- A. Tolbutamide (Orinase)
- B. Lisinopril (Prinivil)
- C. Simvastatin (Zocor)
- D. Losartan (Cozaar)
- E. Chlorpropamide (Diabinese
Correct Answer: A,E
Rationale: Sulfonamides may inhibit the hepatic metabolism of the oral hypoglycemic drugs tolbutamide(Orinase) and chlorpropamide(Diabinese). Elderly clients may be especially sensitive to this reaction. Lisinopril, simvastatin, and losartan are used for cardiac conditions.
Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply.
- A. Ulcerative colitis
- B. Urinary tract infection
- C. Acute otitis media
- D. Upper respiratory tract infection
- E. Osteomyelitis
Correct Answer: A,B,C
Rationale: Sulfonamides are often used to treat ulcerative colitis, urinary tract infection, and acute otitis media.
A nurse is working in an ambulatory care setting that involves seeing clients with infections that require treatment. Which of the following would be important for the nurse to assess in these clients? Select all that apply.
- A. Client's use of self-remedies
- B. Review of lab results
- C. Vital signs
- D. Client's symptoms
- E. Client's general appearance
Correct Answer: A,B,C,D,E
Rationale: When assessing a client who may have an infection, the nurse should gather information about the client's general appearance; vital signs; symptoms, including the length of time the client has been experiencing them; and any self-remedies used. In addition, the nurse should review the results of any laboratory and diagnostic tests.
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.
The health care professional has recommended sulfonamide therapy for a client. While obtaining the client's medical history, the nurse discovers that he is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants?
- A. Increased action of the anticoagulant
- B. Increased risk of anaphylactic shock
- C. Rendering of sulfonamide therapy ineffective
- D. Development of leukopenia
Correct Answer: A
Rationale: Taking sulfonamide drugs when the client 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.