A client is prescribed ferrous sulfate.
Before administering the drug, the nurse reviews the client's medical record.
The nurse would withhold the drug and contact the primary health care provider if the client's history revealed which of the following?

Choice A rationale:

Bacteriostatic. Sulfonamides are a class of antibiotics that work primarily as bacteriostatic agents. They inhibit the growth and reproduction of bacteria by blocking the synthesis of folic acid, which is essential for bacterial DNA and RNA synthesis. By slowing down bacterial growth, sulfonamides give the body's immune system a chance to eliminate the bacteria. Bacteriostatic antibiotics do not directly kill bacteria but rather impede their ability to multiply. This action is a key characteristic of sulfonamides.

Choice B rationale:

Bactericidal. Sulfonamides are not primarily bactericidal. Bactericidal antibiotics directly kill bacteria by disrupting their cell walls, protein synthesis, or other essential processes. Sulfonamides do not have this direct killing effect. They work by inhibiting folic acid synthesis and, as a result, slowing down bacterial growth. While this can eventually lead to bacterial death, the primary action of sulfonamides is bacteriostatic.

Choice C rationale:

Promotor of folic acid activity. This choice is not accurate. Sulfonamides do not promote folic acid activity; rather, they inhibit it. Sulfonamides are structural analogs of para-aminobenzoic acid (PABA), a precursor necessary for folic acid synthesis in bacteria. By competing with PABA, sulfonamides disrupt folic acid production in bacteria, ultimately leading to growth inhibition. Therefore, they are not promoters of folic acid activity.

Choice D rationale:

Bacterial cell metabolizer. Sulfonamides do not metabolize bacterial cells. Instead, they interfere with bacterial metabolism by blocking the synthesis of folic acid. This disruption affects the DNA and RNA synthesis of bacteria, which rely on folic acid derivatives. The primary action of sulfonamides is to inhibit this metabolic pathway, not to metabolize bacterial cells.

Choice A rationale:

This choice is not accurate because the severity of the infection is not the primary reason for the development of a superinfection. Superinfections occur due to disruptions in the normal bacterial flora, not because the drug is less effective in severe infections.

Choice B rationale:

This choice is also inaccurate. Superinfections do not occur as the original infection begins to clear. They are a result of antibiotic therapy, particularly with drugs like fluoroquinolones that disrupt the normal bacterial balance.

Choice C rationale:

Choice D rationale:

This choice is not appropriate as it does not provide the patient with useful information. It's essential to educate the patient about why the superinfection occurred.