Nokea
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.
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A client asks the nurse about drinking cranberry juice to prevent UTIs. The nurse informs the client that it is safe to use, suggesting an intake of which amount daily?
- A. 1 to 2 ounces
- B. 4 to 8 ounces
- C. 8 to 12 ounces
- D. 12 to 16 ounces
Correct Answer: B
Rationale: Cranberry juice is safe for use as a food and for urinary tract health. The recommended dosage is 4 to 8 ounces of juice per day.
A nurse is to obtain a daily urine pH as ordered. The client would most likely be receiving which of the following anti-infectives for a UTI because they work better in acidic urine? Select all that apply.
- A. Methenamine (Hiprex)
- B. Amoxicillin (Amoxil)
- C. Fosfomycin (Monurol)
- D. Nitrofurantoin (Macrodantin)
- E. Nalidixic (NegGram)
Correct Answer: A,D
Rationale: A daily urine pH level may be ordered by the physician for clients taking methenamine (Hiprex) or nitrofurantoin (Macrodantin) for a UTI because they work better in acidic urine.
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 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.
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.