Nokea
The nurse is preparing to administer a prescribed sulfonamide. Which of the following would the nurse do? Select all that apply.
- A. Have the client sit up to take the drug
- B. Give the prescribed drug on an empty stomach
- C. Be sure to administer the drug immediately after a meal
- D. Have the client decrease his fluid intake
- E. Encourage the client to drink additional fluids
Correct Answer: A,B,E
Rationale: Oral medication should be administered to clients only when they are in an upright or sitting position. Sulfonamides should be administered on an empty stomach if tolerated with 8 ounces of water. Increased fluid intake is encouraged to prevent crystalluria.
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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.
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.
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.
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.
A client is being discharged with a prescription for sulfasalazine. Which of the following would the nurse include in the discharge teaching plan? Select all that apply.
- A. Take the drug 1 hour before or 2 hours after meals.
- B. Use protective sunscreen or cover exposed areas when going outside.
- C. Finish the entire course of sulfonamide even if you begin feeling better.
- D. Decrease fluid intake to prevent increased excretion of the drug.
- E. Keep all follow-up appointments
Correct Answer: B,C,E
Rationale: The nurse should teach the client to take sulfasalazine with food or immediately after a meal, to use sunscreen or cover exposed areas to prevent severe sunburn, to increase fluid intake to prevent renal calculi, to finish the entire course of drug even if the symptoms go away, and to keep all follow-up appointments.