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Chapter 06: Antibacterial Drugs: Sulfonamides Introductory Clinical Pharmacology 12th Edition by Susan M Ford

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Chapter 06: Antibacterial Drugs: Sulfonamides Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A client, diagnosed with a urinary tract infection, indicates the use of an herbal product to help prevent and relieve the symptoms. Which herb has the client most likely been using? a. Ginger b. Feverfew c. Saw palmetto d. Cranberry 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. Question Format: Multiple Choice Chapter: 6 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 72, Herbal Considerations 2. The nurse is preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect? a. Prolonged clotting times b. Increased risk of infection c. Decreased antibiotic effect d. Decreased white blood cell count 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. Question Format: Multiple Choice Chapter: 6 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 71, Interactions 3. A nurse is to administer sulfasalazine to a client with ulcerative colitis. Which interventions would be most important while caring for this client? a. Stop dosage if skin turns orange-yellow color. b. Regularly inspect client's stool samples. c. Give the drug on an empty stomach. d. Administer cranberry juice to the client. Answer: B Rationale: While providing care to a client receiving sulfasalazine therapy for ulcerative colitis, the nurse should regularly inspect all stool samples and record their number and appearance. Yellow skin or urine in clients receiving sulfasalazine is normal, and the nurse should not stop the dosage. Sulfasalazine is administered with meals or immediately afterward, not on an empty stomach. Administering cranberry juice is helpful for clients with urinary tract infections, but not for clients with ulcerative colitis. Question Format: Multiple Choice Chapter: 6 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 72, Ongoing Assessment 4. An elderly client receiving treatment for a urinary tract infection is now reporting diarrhea. On assessment, the nurse notes the client has been receiving the appropriate medication as well as drinking cranberry juice. Which factor is most likely the cause of the client's condition? a. Extremely large dosage of cranberry juice b. Lack of activity or exercise c. Occurrence of crystalluria d. Minimized food and fluid intake Answer: A Rationale: Clients may develop gastrointestinal distress such as diarrhea if they have consumed extremely large doses of cranberry juice. The recommended dose is 6 oz of juice twice daily. Cranberry juice on an empty stomach or immediately after dosage will not lead to diarrhea if taken in the recommended amount. Minimized food and fluid intake or lack of exercise does not increase the chances of diarrhea. Crystalluria does not cause diarrhea. Question Format: Multiple Choice Chapter: 6 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 72, Herbal Considerations 5. A nurse is about to administer mafenide to a client. The nurse would be alert for which possible reaction? a. Rash, itching, or other allergic reactions b. Crystals in the urine sample c. Inflammation of the mouth d. Loss of appetite Answer: A Rationale: The nurse should assess for allergic reactions such as rash, itching, edema, and urticaria when administering mafenide. Topical sulfonamides like mafenide do not cause crystalluria, inflammation of the mouth, or loss of appetite. Question Format: Multiple Choice Chapter: 6 Learning Objective: 7 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 71, Other Reactions 6. After administering sulfonamides to a client, the nurse observes the client has developed a fever, cough, and muscular aches, as well as lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which possible adverse reaction?

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