Chapter 46: Urinary Tract Anti-Infectives and Other Urinary Drugs Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. The nursing instructor is teaching a session explaining the various drugs used to treat urinary tract infections. The instructor determines the session is successful when the students correctly choose which organ as most often affected by infections? a. Bladder b. Kidney c. Urethra d. Ureters Answer: A Rationale: The urinary tract consists of the following anatomic structures: kidneys, ureters, bladder, prostate gland, and urethra. UTIs most commonly affect the bladder. Question format: Multiple Choice Chapter: 46 Learning Objective: 1 Cognitive Level: Apply Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 624, Figure 46.1 Routes of infection in the urinary tract 2. A client with a UTI is experiencing dysuria. The nurse would expect which drug to be prescribed? a. Nitrofurantoin b. Oxybutynin c. Sulfamethoxazole/trimethoprim d. Phenazopyridine Answer: D Rationale: Phenazopyridine is a urinary tract analgesic that is useful in treating dysuria caused by a UTI. Sulfamethoxazole/trimethoprim is a combination urinary anti-infective drug. Nitrofurantoin is an anti-infective drug used for UTIs. Oxybutynin is an antispasmodic drug used for overactive bladder. Question format: Multiple Choice Chapter: 46 Learning Objective: one Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 624, Actions and Uses 3. A nurse caring for a client taking warfarin develops a UTI. The nurse should monitor the client for increased risk of bleeding if which anti-infective is prescribed? a. Fosfomycin b. Methenamine c. Sulfamethoxazole d. Nitrofurantoin Answer: C Rationale: Sulfamethoxazole, when administered concomitantly with warfarin, can increase a client's risk for bleeding. This interaction is not associated with fosfomycin, methenamine, or nitrofurantoin. Nitrofurantoin should be used cautiously with magnesium trisilicate or magaldrate, and anticholinergics due to potential adverse reactions. Methenamine should not be used with antacids containing sodium bicarbonate or cosium carbonate due to potential adverse reactions. Fosfomycin should be used cautiously with metoclopramide due to adverse reactions. Question format: Multiple Choice Chapter: 46 Learning Objective: 1 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 625, Anti-Infectives 4. A nurse has administered amoxicillin to a client for a UTI. The nurse will prioritize which assessment finding on the ongoing assessment? a. Abdominal cramps b. Vaginitis c. Bladder irritation d. Stomatitis Answer: D Rationale: The nurse should monitor for stomatitis in the client, which is an adverse reaction to amoxicillin, an anti-infective drug. Vaginitis is an adverse reaction to an anti-infective drug called fosfomycin. Abdominal cramps and bladder irritation are adverse reactions to the anti-infective drug methenamine. Question format: Multiple Choice Chapter: 46 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 628, Summary Drug Table 5. A nurse is preparing to administer methenamine to a client for UTI. The nurse will question this order if the client is noted to be allergic to which substance? a. Sulfa b. Tartrazine c. Shellfish d. Penicillin Answer: B Rationale: Clients who are allergic to tartrazine, a food dye, should not receive methenamine. Allergies to sulfa drugs, penicillins, or shellfish are not noted to interact adversely with methenamine. Question format: Multiple Choice Chapter: 46 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 625, Contraindications and Precautions 6. A nurse is teaching a client how to properly administer fosfomycin. The nurse determines the session is successful when the client correctly points out they will administer the drug in which manner? a. Administer the drug every 3 hours. b. Dissolve the drug in 90–120 mL of hot water. c. Ingest the drug immediately after mixing with water. d. Administer the drug on an empty stomach.