A client who following prescribed multiple medications for recurring urinary tract infections tells the nurse that her urine has turned red-orange. Which of the following prescribed medications does the nurse suspect is responsible for this change?

Nitrofurantoin (Macrobid)

Sulfamethoxzole-trimethoprim (SMX TMP) Bactrim)

This is expected with a UTI not related to medications.

Phenazopryidine (Pyridium)

Answer and Explanation

The Correct Answer is D

A) Nitrofurantoin (Macrobid): While nitrofurantoin is commonly prescribed for urinary tract infections (UTIs), it does not typically cause a red-orange discoloration of the urine. Nitrofurantoin may cause other side effects, such as gastrointestinal upset or pulmonary issues, but urine discoloration is not a common or expected side effect.

B) Sulfamethoxazole-trimethoprim (SMX TMP, Bactrim): Sulfamethoxazole-trimethoprim is another common medication for UTIs, but it does not cause urine to turn red-orange. Some individuals may experience allergic reactions, rash, or gastrointestinal side effects, but urine discoloration is not typically associated with this medication.

C) This is expected with a UTI not related to medications: While it’s true that UTIs can cause changes in urine color due to blood or infection, the red-orange discoloration specifically linked to a UTI is often caused by medications, not the infection itself. Therefore, this statement is not accurate in explaining the cause of the urine color change.

D) Phenazopyridine (Pyridium): This is the correct answer. Phenazopyridine is a medication commonly used to alleviate urinary tract pain and discomfort. One of its well-known side effects is causing urine to turn a red-orange color. This discoloration is harmless and typically resolves once the medication is discontinued. However, patients should be informed about this effect to avoid unnecessary concern.

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Correct Answer is B

Explanation

A. Pernicious anemia:
Pernicious anemia is primarily caused by a deficiency in vitamin B12, often due to a lack of intrinsic factor needed for absorption in the gut. It typically presents with symptoms like weakness, fatigue, and neurological manifestations such as numbness or tingling. However, the client’s presentation does not suggest a vitamin B12 deficiency or neurological signs. Additionally, pernicious anemia is not typically associated with heavy menstrual periods,
which are more indicative of blood loss anemia.

B. Blood loss anemia:
Blood loss anemia is the most likely diagnosis in this case, especially in the context of heavy menstrual periods, which can cause significant blood loss over time. The client’s hemoglobin level of 6.9 g/dL indicates severe anemia, which is consistent with the cumulative effects of chronic blood loss. This type of anemia results from a decrease in red blood cell count due to bleeding, which can lead to symptoms like weakness, fatigue, and pallor.

C. Sickle cell anemia:
Sickle cell anemia is a genetic condition characterized by abnormally shaped red blood cells, which can lead to hemolysis and episodes of pain. While it can cause symptoms like fatigue and weakness, sickle cell anemia typically presents earlier in life and is more associated with episodes of severe pain and organ damage. Additionally, the patient’s history does not mention episodes of pain or other hallmark signs of sickle cell disease, such as swelling in the hands or feet or recurrent infections.

D. Aplastic anemia:
Aplastic anemia occurs when the bone marrow fails to produce enough blood cells, including red blood cells, white blood cells, and platelets. It presents with symptoms like weakness, fatigue, frequent infections, and bruising. Although this client does have anemia, the lack of additional signs (such as petechiae, infections, or bleeding) makes this diagnosis less likely. Aplastic anemia is also usually diagnosed with bone marrow biopsy, which is not suggested by this client's presentation.

A. Hemoglobin and hematocrit count B. CD4+ count cell C. Western blot D. Enzyme-linked immunosorbent assay (ELISA)

Correct Answer is B

Explanation

A. Hemoglobin and hematocrit count:
Hemoglobin and hematocrit levels are useful in assessing overall blood volume and oxygen-carrying capacity. While these tests can help identify anemia or other hematologic abnormalities that might occur in HIV-infected individuals, they do not provide specific information regarding the stage of HIV infection or the immune function. Therefore, they are not the most helpful for determining the stage of the disease.

B. CD4+ count cell:
The CD4+ count is the most important laboratory test for assessing the progression of HIV. CD4+ T cells are critical components of the immune system, and their count reflects the level of immune suppression in the body. As HIV progresses, the CD4+ count decreases, making the individual more vulnerable to opportunistic infections. A low CD4+ count (typically below 200 cells/mm³) indicates that the individual has progressed to acquired immunodeficiency syndrome (AIDS). Therefore, the CD4+ count provides the most direct insight into the stage of HIV infection.

C. Western blot:
The Western blot test is used to confirm an HIV diagnosis after an initial positive screening test, such as the ELISA. It is not used to assess the stage of the disease. While it helps to confirm the presence of HIV antibodies, it does not provide information about immune function or the progression of the disease.

D. Enzyme-linked immunosorbent assay (ELISA):
The ELISA is a screening test used to detect antibodies against HIV. If the ELISA test is positive, it is usually followed by a confirmatory test (such as the Western blot). While ELISA is important for diagnosing HIV infection, it does not provide information about the current stage or progression of the disease. Therefore, it is not the most helpful test for assessing the stage of HIV infection once the diagnosis is established.

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A client who following prescribed multiple medications for recurring urinary tract infections tells the nurse that her urine has turned red-orange. Which of the following prescribed medications does the nurse suspect is responsible for this change?

Nursing Test Bank

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