Nokea
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.
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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 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.
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 fosfomycin for the treatment of an acute bacterial UTI. Which of the following interventions should the nurse include in the teaching plan for the client about this drug?
- A. Ensure that the drug is administered every 3 hours.
- B. Administer the drug after dissolving it in 90 to 120 mL of hot water.
- C. Ensure that the drug is administered immediately after mixing with water.
- D. Administer the drug on an empty stomach.
Correct Answer: C
Rationale: The nurse should instruct the client to take the drug immediately after mixing it with water. The nurse need not instruct the client to take the drug at an interval of 3 hours, to take the drug after dissolving it in 90 to 120 mL of hot water, or to take the drug on an empty stomach. Fosfomycin, which comes in dry form, should be dissolved in 90 to 120 mL water, but not hot water. The nurse should instruct the client to take the drug with food to prevent gastric upset, which occurs with the administration of fosfomycin.
A nurse monitoring a hospitalized client with a UTI notifies the physician if which of the following occur with drug therapy? Select all that apply.
- A. Fever
- B. Poor fluid intake
- C. Decreased urinary output
- D. Appearance of concentrated urine
- E. Worsening of UTI symptoms
Correct Answer: A,B,C,D,E
Rationale: A nurse monitoring a hospitalized client with a UTI notifies the physician if any of the following occur: fever, poor fluid intake, decreased urinary output, appearance of concentrated urine, or worsening of UTI symptoms.