Nokea
A nurse is administering methenamine to a client with a UTI. Which of the following would the nurse instruct the client to avoid?
- A. Ascorbic acid
- B. Sodium bicarbonate
- C. Acetaminophen
- D. Ibuprofen
Correct Answer: B
Rationale: An increased urinary pH (alkaline urine) decreases the effectiveness of methenamine. Therefore, to avoid raising the urine pH when taking methenamine, the client should not use antacids containing sodium bicarbonate or sodium carbonate.
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Based on the nurse's understanding about anti-infectives, the nurse would administer nitrofurantoin cautiously to a client with which condition? Select all that apply.
- A. Hypertension
- B. Diabetes
- C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- D. Cerebral arteriosclerosis
- E. Myasthenia gravis
Correct Answer: B,C,D
Rationale: A nurse should administer nitrofurantoin cautiously to a client with the following conditions: diabetes, G6PD deficiency, and cerebral arteriosclerosis.
A nurse is caring for a client receiving amoxicillin for the treatment of an acute bacterial urinary tract infection. After administering the drug, the nurse would be alert for which of the following as an adverse reaction to the drug?
- A. Abdominal cramps
- B. Vaginitis
- C. Bladder irritation
- D. Stomatitis
Correct Answer: D
Rationale: The nurse should monitor for stomatitis in the client, which is an adverse reaction to amoxicillin, an anti-infective drug. Vaginitis is an adverse reaction to an anti-infective drug called fosfomycin. Abdominal cramps and bladder irritation are adverse reactions to the anti-infective drug methenamine.
The nurse is developing a plan of care for a client who is receiving an anti-infective drug for treatment of a UTI. The nurse has identified a nursing diagnosis of Impaired Urinary Elimination. Which of the following would the nurse include?
- A. Encouraging a fluid intake of at least 2000 mL/day
- B. Offering the client orange juice when administering the medication
- C. Monitoring urine output every 1 to 2 hours
- D. Checking the urine pH every 4 hours
Correct Answer: A
Rationale: Encouraging a fluid intake of at least 2000 mL/day would be appropriate. The nurse should offer fluids such as water, cranberry juice, or prune juice rather than orange juice or other citrus or vegetable juices. Intake and output are usually measured every 8 hours, not every 1 to 2 hours. Urine pH measurements would be appropriate if the client was receiving methenamine or nitrofurantoin.
A nurse is preparing to administer phenazopyridine to a client. To help promote maximum effectiveness, the nurse would expect to administer this drug at which time?
- A. Before meals
- B. At bedtime
- C. Around the clock
- D. After meals
Correct Answer: D
Rationale: Phenazopyridine is administered after meals to prevent GI upset.
When describing the adverse reactions associated with anti-infectives for UTIs, which of the following would the nurse explain as being most common?
- A. Gastrointestinal
- B. Dermatologic
- C. Neurologic
- D. Urologic
Correct Answer: A
Rationale: Although dermatologic reactions such as rash, pruritus, and photosensitivity reactions can occur and neurologic reactions such as dizziness, drowsiness, headache, blurred vision, and weakness can occur, adverse reactions associated with anti-infectives are primarily gastrointestinal in nature.