Nokea
A nurse informs a client prescribed nitrofurantoin (Macrodantin) and her family that pulmonary reactions have been reported with the drug's use hours to 3 weeks after the drug therapy is initiated. The nurse determines that the teaching was successful when the client states that she will notify the primary health care provider if which of the following occur? Select all that apply.
- A. Dyspnea
- B. Chest pain
- C. Cough
- D. Fever
- E. Chills
Correct Answer: A,B,C,D,E
Rationale: Signs and symptoms of an acute pulmonary reaction to nitrofurantoin (Macrodantin) include dyspnea, chest pain, cough, fever, and chills, and any of these should be reported to the physician immediately.
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A nurse is educating a client receiving sulfamethoxazole/trimethoprim (Septra) about common dermatologic adverse reactions. Which of the following would the nurse include in the teaching? Select all that apply.
- A. Rash
- B. Stevens-Johnson syndrome
- C. Photosensitivity
- D. Exfoliative dermatitis
- E. Pruritus
Correct Answer: A,C,E
Rationale: Common dermatologic adverse reactions seen with the use of sulfamethoxazole/trimethoprim (Septra) include rash, photosensitivity, pruritus, and urticaria.
When describing the use of anti-infectives to treat urinary tract infections, which of the following would the nurse identify as the most common structure affected?
- A. Bladder
- B. Kidney
- C. Prostate gland
- D. Urethra
- E. Ureters
Correct Answer: A
Rationale: The urinary tract consists of the following anatomic structures: kidneys, ureters, bladder, prostate gland, and urethra. UTIs most commonly affect the bladder.
A nurse is conducting an in-service presentation for a group of nurses about UTIs and hospitalized clients. When discussing preventive measures, the nurse would identify which of the following as the primary nursing intervention for prevention?
- A. Proper perineal hygiene
- B. Use of urinary acidifiers
- C. Hand hygiene
- D. Routine urinalysis
Correct Answer: C
Rationale: UTIs may affect the hospitalized client or nursing home resident with an indwelling catheter or a disorder such as a stone in the urinary tract. The primary nursing intervention to prevent UTIs in the hospitalized client is good hand hygiene or handwashing. Proper perineal hygiene may be helpful but not as effective as hand hygiene. The use of urinary acidifiers is appropriate to maintain pH of the urine but not prevent UTIs. Routine urinalysis would help identify potential infections but not prevent them.
A nurse is caring for a client receiving methenamine as outpatient treatment for chronic bacterial UTIs. Which instruction should the nurse include in the teaching plan for the client about the administration of the drug?
- A. Avoid prolonged exposure to sunlight.
- B. Increase the intake of milk products.
- C. Avoid an excessive intake of citrus fruits.
- D. Take the drug preferably with food.
Correct Answer: C
Rationale: The nurse should instruct the client taking the anti-infective methenamine to avoid an excessive intake of citrus fruits. The nurse need not instruct the client taking methenamine to avoid prolonged exposure to sunlight, to increase the intake of milk products, or to take the drug preferably with food. Instead, the nurse should instruct the client to avoid milk and milk products when the client is taking methenamine.
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.