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Chapter 88

Terms in this set (12)

A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) [Bactrim] for a urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for:
a.
birth defects.
b.
hypoglycemia.
c.
rash.
d.
kernicterus.
d.
kernicterus.
A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct?
a.
"Immunosuppressed patients are folate deficient."
b.
"Patients who are immunosuppressed are more likely to develop resistance."
c.
"Sulfonamides are bacteriostatic and depend on host immunity to work."
d.
"Sulfonamides intensify the effects of immunosuppression."
c.
"Sulfonamides are bacteriostatic and depend on host immunity to work."
A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient, the nurse will tell the patient that it will be important to:
a.
drink 8 to 10 glasses of water each day.
b.
eat foods that are high in potassium.
c.
take the medication with food.
d.
take folic acid supplements.
a.
drink 8 to 10 glasses of water each day.
A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching?
a.
"I need to drink extra fluids while taking this medication."
b.
"I need to use sunscreen when taking this drug."
c.
"I should call my provider if I develop a rash while taking this drug."
d.
"I should stop taking this drug when my symptoms are gone."
d.
"I should stop taking this drug when my symptoms are gone."
A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient?
a.
Patients with diabetes have an increased risk of an allergic reaction.
b.
Patients taking TMP/SMZ may need increased doses of glipizide.
c.
The patient should check the blood glucose level more often while taking TMP/SMZ.
d.
The patient should stop taking the glipizide while taking the TMP/SMZ.
c.
The patient should check the blood glucose level more often while taking TMP/SMZ.
A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the two are similar products, and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine?
a.
It causes increased pain when the medication is applied.
b.
It has a broader spectrum of antimicrobial sensitivity.
c.
It has antibacterial effects related to release of free silver.
d.
It suppresses renal excretion of acid, causing acidosis.
c.
It has antibacterial effects related to release of free silver.
A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching?
a.
"Bacterial resistance to trimethoprim is relatively uncommon."
b.
"Resistance among gonococci, streptococci, and meningococci to sulfonamides is high."
c.
"Resistance to both agents can occur by spontaneous mutation of organisms."
d.
"Resistance to sulfonamides is less than resistance to trimethoprim."
d.
"Resistance to sulfonamides is less than resistance to trimethoprim."
A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do?
a.
Contact the provider to request a different antibiotic for this patient.
b.
Obtain frequent blood glucose determinations while giving TMP/SMZ.
c.
Suggest that the patient take a potassium supplement while taking TMP/SMZ.
d.
Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.
a.
Contact the provider to request a different antibiotic for this patient.
A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do?
a.
Administer the dose and request an order for an antipyretic medication.
b.
Withhold the dose and request an order for an antihistamine to treat the rash.
c.
Withhold the dose and notify the provider of the symptoms.
d.
Request an order for intravenous TMP/SMZ, because the patient is getting worse.
c.
Withhold the dose and notify the provider of the symptoms.
A nurse is caring for an African American patient who has been admitted to the unit for long-term antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would be correct to suspect that the patient has developed:
a.
Stevens-Johnson syndrome.
b.
kernicterus.
c.
hepatotoxicity.
d.
hemolytic anemia.
d.
hemolytic anemia.
A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to:
a.
change the antibiotic to TMP/SMZ.
b.
increase the dose of the glipizide.
c.
monitor the patient's electrolytes closely.
d.
monitor the patient's coagulation levels.
d.
monitor the patient's coagulation levels.
A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely?
a.
Calcium
b.
Chloride
c.
Potassium
d.
Sodium
c.
Potassium
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