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A nurse is caring for a client who is being administered sulfasalazine. Which of the following instructions should the nurse include to ensure that the client gets the full benefits of the treatment?
- A. Take dosage while eating or immediately after eating.
- B. Increase food intake for the duration of sulfonamide therapy.
- C. Take the drug with a full glass of milk instead of water.
- D. Drink at least two to three 8-ounce glasses of fluid every day
Correct Answer: A
Rationale: The nurse should administer sulfasalazine with food or immediately afterward. Increasing the food intake during sulfonamide therapy is not necessary, as long as a proper diet is maintained and the physician's recommendations are followed. Two to three 8-ounce glasses of fluid is not enough; the client should drink at least eight to ten 8-ounce glasses of fluid every day. All drugs should be taken with water and not milk, juice, or any other liquid, unless specifically instructed by the physician.
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After teaching the client about taking his prescribed sulfonamide therapy, the nurse determines that the client needs additional teaching when he states which of the following?
- A. I should take the drug with a large glass of water each time.
- B. I can take the drug at different times of the day each day.
- C. I have to finish the full prescription for the medication.
- D. I should call my doctor if my symptoms seem to get worse
Correct Answer: B
Rationale: It is important that the client takes the drug at the scheduled intervals consistently throughout the course of the therapy because a certain amount of the drug must be in the body at all times for the infection to be controlled. The client is correct in taking the drug with a large glass of water each time, finishing the full prescription, and calling the doctor if symptoms get worse.
A client is diagnosed with a urinary tract infection. When obtaining the client's drug history, the client reports using an herbal product in the past to prevent and relieve the symptoms. Which of the following would the client most likely identify?
- A. Ginger
- B. Feverfew
- C. Saw palmetto
- D. Cranberry
Correct Answer: D
Rationale: Cranberries and cranberry juice are commonly used remedies for preventing and relieving symptoms of UTIs. However, if an individual suspects a UTI, medical attention is necessary.
The nurse suspects that a client who is taking a sulfonamide has leukopenia. Which assessment findings would support this suspicion? Select all that apply.
- A. Sore throat
- B. Cough
- C. Nausea
- D. Photosensitivity
- E. Bruising
Correct Answer: A,B
Rationale: Antibiotics including sulfonamides can lead to leukopenia, which would be manifested by fever, sore throat, or cough. Thrombocytopenia is also possible and would be manifested by easy bruising or unusual bleeding from minor to moderate trauma. Nausea and photosensitivity are adverse reactions to sulfonamides.
A nurse is caring for a client with a urinary tract infection. After administering a sandwich and a large glass of cranberry juice to a client, the nurse observes that the client has developed diarrhea. Which of the following is the most likely cause of the client's condition?
- A. Extremely large dosage of cranberry juice
- B. Lack of activity or exercise
- C. Occurrence of crystalluria
- D. Minimized food and fluid intake
Correct Answer: A
Rationale: Clients may develop gastrointestinal distress such as diarrhea if they have consumed extremely large doses of cranberry juice. The recommended dose is 6 ounces of juice twice daily. Cranberry juice on an empty stomach or immediately after dosage will not lead to diarrhea if taken in the recommended amount. Minimized food and fluid intake or lack of exercise does not increase the chances of diarrhea. Crystalluria does not cause diarrhea.
The health care professional has recommended sulfonamide therapy for a client. While obtaining the client's medical history, the nurse discovers that he is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants?
- A. Increased action of the anticoagulant
- B. Increased risk of anaphylactic shock
- C. Rendering of sulfonamide therapy ineffective
- D. Development of leukopenia
Correct Answer: A
Rationale: Taking sulfonamide drugs when the client is already taking oral anticoagulants may result in increased action of the anticoagulants. Anaphylactic shock and leukopenia are some of the adverse reactions of sulfonamides but are not associated with mixing sulfonamides and anticoagulants. Oral anticoagulants do not decrease the effectiveness of sulfonamides.