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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.
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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.
When developing the plan of care for a client receiving sulfonamides for treatment of a urinary tract infection, the nurse identifies actions for encouraging fluid intake and monitoring intake and output based on which nursing diagnosis?
- A. Risk for Fluid Imbalance
- B. Impaired Urinary Elimination
- C. Risk for Ineffective Renal Perfusion
- D. Stress Incontinence
Correct Answer: B
Rationale: A client with a urinary tract infection already is experiencing an alteration in urinary elimination. Because one adverse effect of the sulfonamide drugs is altered elimination patterns, it is important to help the client maintain adequate fluid intake and output. The nurse would encourage clients to increase fluid intake to 2000 mL or more per day to prevent crystalluria and stones (calculi) forming in the genitourinary tract, as well as to aid in removing microorganisms from the urinary tract. It is important to measure and record the client's intake and output every 8 hours and notify the primary health care provider if the urinary output decreases or the client fails to increase his or her oral intake. If the client is unable to maintain adequate intake, then he or she would be at risk for fluid imbalance. If renal injury would occur, then the client would be at risk for ineffective renal perfusion. Bladder training would be an appropriate intervention to address stress incontinence.
A 60-year-old client who is on sulfonamide therapy has impaired urinary elimination. She does not want to increase her oral fluid intake because of fear of incontinence. Which of the following nursing interventions would be most appropriate?
- A. Inform the client that there is no need to increase fluid intake.
- B. Inform the client that increasing fluid intake will not result in incontinence.
- C. Teach the client the times to take fluids to maintain continence.
- D. Increase fluid intake by 1000 mL instead of 2000 mL to avoid incontinence
Correct Answer: C
Rationale: The nurse's responsibility is to help the client overcome the fear of incontinence and to teach her when to take fluids to maintain continence. Instead of telling the client that increasing fluid intake has no effect on continence, the nurse should focus on helping the client with her problems of incontinence. The nurse should instruct the client to increase the fluid intake by at least 2000 mL, instead of only 1000 mL; however, this will not help control incontinence.
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 with a fever is ordered to receive sulfonamide therapy for an infection. The nurse needs to evaluate the client for which of the following during the course of therapy? Select all that apply.
- A. Response to drug therapy
- B. Elevated blood glucose levels
- C. Mental status changes
- D. Occurrence of adverse reactions
- E. Decrease in temperature
Correct Answer: A,D,E
Rationale: During the course of therapy, the nurse evaluates the client at periodic intervals for response to the drug, including relief of symptoms and decrease in temperature, as well as the occurrence of any adverse reactions.