Nokea
A nurse is caring for an older adult client who is hospitalized. The client develops a UTI and is receiving prescribed anti-infective therapy. Which of the following should the nurse perform while caring for this client?
- A. Document symptoms of the client's condition.
- B. Monitor the client's vital signs every 4 hours.
- C. Document the client's urine output every hour.
- D. Assess the client for bladder distension.
Correct Answer: B
Rationale: When caring for a client with a UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor the vital signs of the client every 4 hours after administration of the drug or as ordered by the primary health care provider. Any significant rise in body temperature is reported to the primary health care provider because the methods of reducing the fever or culture and sensitivity tests may need to be repeated. The nurse should document the symptoms experienced by the client and assess the client for bladder distension as part of the preadministration assessment before administering the drug to the client. The nurse need not document the client's urine output every hour or monitor the client's respiratory rate in this case.
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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.
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 client with a UTI is experiencing dysuria. The nurse would expect which of the following to be prescribed?
- A. Nitrofurantoin (Macrodantin)
- B. Oxybutynin (Ditropan)
- C. Sulfamethoxazole/trimethoprim (Bactrim)
- D. Phenazopyridine (Pyridium)
Correct Answer: D
Rationale: Phenazopyridine (Pyridium) is a urinary tract analgesic that is useful in treating dysuria caused by a UTI.
A nurse caring for a client taking which of the following drugs may notice increased adverse reactions if the client was prescribed nitrofurantoin (Macrodantin) resulting from an increased absorption of nitrofurantoin (Macrodantin)? Select all that apply.
- A. Benztropine (Cogentin)
- B. Simvastatin (Zocor)
- C. Tiotropium (Spiriva)
- D. Albuterol (Proventil)
- E. Dicyclomine (Bentyl)
Correct Answer: A,C,E
Rationale: Anticholinergic drugs, like benztropine (Cogentin), tiotropium (Spiriva), and dicyclomine (Bentyl), can cause delayed gastric emptying, leading to increased absorption of nitrofurantoin (Macrodantin), which may result in increased adverse reactions.
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.