Nokea
A nurse caring for a client being treated with nitrofurantoin (Macrodantin) for a UTI should ask the client specifically about resolution of which of the following symptoms during ongoing assessment? Select all that apply.
- A. Urgency
- B. Frequency
- C. Pressure
- D. Burning during urination
- E. Pain during urination
Correct Answer: A,B,C,D,E
Rationale: Clinical manifestations of a UTI include urgency, frequency, pressure, burning and pain on urination, and pain caused by spasm in the region of the bladder and the suprapubic area and should be assessed by the nurse during ongoing assessment to determine effectiveness of drug therapy.
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A nurse is developing a teaching plan for a client diagnosed with a UTI and prescribed nitrofurantoin (Macrodantin). The nurse would warn the client about which of the following common gastrointestinal adverse reactions? Select all that apply.
- A. Anorexia
- B. Ileus
- C. Toxic megacolon
- D. Nausea
- E. Diarrhea
Correct Answer: A,D,E
Rationale: Common gastrointestinal adverse reactions seen with the use of nitrofurantoin (Macrodantin) include anorexia, nausea, vomiting, diarrhea, and abdominal pain.
A nurse is caring for a client who is being prescribed phenazopyridine. The client is distressed on seeing that the urine is exhibiting a reddish-orange discoloration. Which response by the nurse would be most appropriate?
- A. We will have to get a specimen for a urinalysis.
- B. I will have to notify the primary health care provider immediately.
- C. You will need to increase your fluid intake.
- D. This discoloration is a normal result of the medication. Nothing is wrong.
Correct Answer: D
Rationale: The nurse should inform the client that phenazopyridine may cause a reddish-orange discoloration of the urine, which is normal, so there is no cause to worry. Periodic urinalyses are conducted as part of the ongoing assessment when caring for a client with a UTI. Since the reddish-orange discoloration of the urine is normal, the nurse need not notify the primary health care provider immediately. The nurse also need not ask the client to increase intake of fluids.
After teaching a client about her prescribed anti-infective therapy for her UTI, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I can stop the drug once my symptoms disappear.
- B. I can take the medication with food or meals.
- C. I can drink pineapple juice to keep things acidic.
- D. I'll call my primary health care provider if I don't feel better in about 3 days.
- E. I should avoid drinking any beverages that contain alcohol.
Correct Answer: B,D,E
Rationale: The client should complete the full course of therapy even with symptom relief to ensure that all bacteria have been eliminated from the urinary tract. The client should take the drug with food or meals. Cranberry juice, prune juice, and water are recommended. Alcohol and citrus juices such as orange or pineapple juice are to be avoided. The client should notify her primary health care provider if the symptoms do not subside within 3 to 4 days.
After nitrofurantoin is administered to a client with an acute bacterial UTI, assessment reveals dyspnea, chest pain, cough, fever, and chills. Which of the following actions would be most appropriate?
- A. Monitor client for tightness of the chest.
- B. Offer fluids to the client at regular intervals.
- C. Provide oxygen support to the client.
- D. Withhold the drug and contact the primary health care provider.
Correct Answer: D
Rationale: The nurse should immediately notify the primary health care provider and withhold the next dose of the drug until the client is seen by the primary health care provider if acute pulmonary reactions are observed in the client. The nurse should monitor the client for signs of a nonproductive cough or malaise, which may indicate a chronic pulmonary reaction, which may occur during prolonged therapy. Tightness of the chest is not known to occur in the case of a chronic pulmonary reaction, so the nurse need not monitor the client for this. The nurse offers fluids at regular intervals to elderly clients who develop decreased thirst sensation as an adverse reaction to the urinary tract anti-infectives.
A nurse caring for a client taking warfarin (Coumadin) develops a UTI. The nurse should monitor the client for increased risk of bleeding if which of the following anti-infectives is prescribed?
- A. Amoxicillin
- B. Methenamine
- C. Sulfamethoxazole
- D. Nitrofurantoin
Correct Answer: C
Rationale: Sulfamethoxazole, when administered concomitantly with warfarin (Coumadin), can increase a client's risk for bleeding. This interaction is not associated with amoxicillin, methenamine, or nitrofurantoin.