Nokea
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.
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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 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.
A nurse caring for a client taking warfarin (Coumadin) develops a UTI. The nurse should monitor the client for increased risk of bleeding if which of the following anti-infectives is prescribed?
- A. Amoxicillin
- B. Methenamine
- C. Sulfamethoxazole
- D. Nitrofurantoin
Correct Answer: C
Rationale: Sulfamethoxazole, when administered concomitantly with warfarin (Coumadin), can increase a client's risk for bleeding. This interaction is not associated with amoxicillin, methenamine, or nitrofurantoin.
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 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.