Nokea
After teaching a group of nursing students about the action of sulfonamides, the instructor determines that the teaching was successful when the students state that the action of this class of drugs is primarily which of the following?
- A. Bacteriostatic
- B. Bactericidal
- C. Promotor of folic acid activity
- D. Bacterial cell metabolizer
Correct Answer: A
Rationale: The sulfonamides are primarily bacteriostatic because of their ability to inhibit the activity of folic acid in bacterial cell metabolism. They are not bactericidal.
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A client who is being discharged has been instructed to continue with sulfonamide therapy for a week. Which of the following points should the nurse include in the teaching plan to educate the client about the therapy?
- A. Discontinue dosage if symptoms of infection disappear.
- B. Take the drug a few minutes before a meal.
- C. Take any off-the-shelf medication if fever occurs.
- D. Ensure that all follow-up appointments are met
Correct Answer: D
Rationale: The nurse's plan should include educating the client about the importance of keeping the follow-up appointments. The nurse should instruct the client to adhere to the dosage schedule and not discontinue it even if the symptoms of the infection have gone. The client should inform the primary health care provider if fever, skin rash, or nausea occurs during the therapy. The client should be instructed to take the drug on an empty stomach (at least 2 hours before or after a meal) and not just before a meal.
A client develops a cough and fever and laboratory test results reveal leukopenia after the client receives sulfonamide therapy. When developing the client's plan of care, the nurse would identify which nursing diagnosis?
- A. Impaired Urinary Elimination
- B. Impaired Skin Integrity
- C. Risk for Secondary Infection
- D. Deficient Knowledge
Correct Answer: C
Rationale: Fever and leukopenia suggest an infection, which can occur secondarily with sulfonamide therapy. Therefore, Risk for Infection would be the most appropriate nursing diagnosis. Impaired Urinary Elimination would be appropriate if the client was experiencing changes in urinary output. Impaired Skin Integrity would be appropriate if the client developed a rash or hypersensitivity reaction. Deficient Knowledge would be appropriate if the client lacked understanding of the drug therapy, which is not evident in this situation.
A nurse is preparing a plan of care for an older adult client who is receiving sulfonamide therapy. Which of the following would the nurse include in the plan of care to reduce the likelihood of causing renal damage? Select all that apply.
- A. Administer sulfonamides once daily.
- B. Increase fluid intake up to 2000 mL if tolerated.
- C. Use sulfonamides cautiously in clients with renal impairment.
- D. Administer the dose intravenously instead of orally.
- E. Ask the prescriber to change the medication ordered
Correct Answer: B,C
Rationale: Older adults experience a decline in renal function with aging. Therefore, sulfonamides must be used cautiously in older clients. In addition, increasing fluid intake up to 2000 mL daily can decrease the likelihood of causing renal damage in older clients. The drug is administered throughout the day, not as a once-daily dose. Sulfonamides can affect renal function regardless of the route administered. Asking the prescriber to change the medication ordered may be appropriate but is not necessary as long as the drug is administered cautiously and the client is monitored closely.
A client is prescribed sulfadiazine one tablet twice daily for 10 days. When reviewing the client's history, the nurse notes that the client is also taking warfarin. The nurse would be alert for which of the following?
- A. Prolonged clotting times
- B. Increased risk of infection
- C. Decreased antibiotic effect
- D. Decreased white blood cell count
Correct Answer: A
Rationale: When warfarin and sulfonamides are given concomitantly, an increase in action of the anticoagulant is seen, leading to an increase in clotting time, such as PT/INR, and an increased risk of bleeding. An increased risk of infection and a decrease in the white blood cell count would occur when a sulfonamide is given with methotrexate. The combination of warfarin and sulfonamide does not impact the effect of the antibiotic.
When reviewing the medical records of several clients who are prescribed sulfonamide therapy, the nurse would expect laboratory findings related to which bacteria? Select all that apply.
- A. Pseudomonas aeruginosa
- B. Escherichia coli
- C. Klebsiella pneumoniae
- D. Streptococcus pyogenes
- E. Staphylococcus aureus
Correct Answer: B,C,E
Rationale: Sulfonamides are often used to control infections caused by both gram-negative and gram-positive bacteria, such as Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Typically, sulfonamides are not used to treat infections caused by Pseudomonas aeruginosa or Streptococcus pyogenes.