A nurse is caring for a client who is receiving warfarin therapy.
Which of the following medications should the nurse expect to administer if the client develops bleeding as an adverse effect of the medication? (Select all that apply.).

Choice A rationale:

Sulfonamides can increase the risk of crystalluria, which may lead to kidney stones. Adequate fluid intake can help dilute the urine and reduce the risk of crystalluria and kidney stone formation. This is a relevant and appropriate response by the nurse.

Choice B rationale:

Sulfonamides can make the skin more sensitive to sunlight, increasing the risk of sunburn. However, increasing fluid intake is primarily to prevent kidney stone formation, not a reaction to sunlight.

Choice C rationale:

While maintaining adequate hydration does help prevent dehydration, this answer does not directly address the potential side effects or risks associated with sulfonamide use. It is a bit too general and doesn't provide specific information related to the medication.

Choice D rationale:

Sulfonamides can affect blood counts in some cases, but maintaining adequate fluid intake is not primarily related to preventing low blood counts. It's more about mitigating the specific side effects associated with sulfonamide use, such as crystalluria and kidney stones.

Choice A rationale:

Tetracyclines are not narrow-spectrum antibiotics. They are broad-spectrum antibiotics. Tetracyclines are effective against a wide range of bacteria, including both Gram-positive and Gram-negative organisms. This is important in treating various infections, but it also means they can disrupt the normal flora of the gut, potentially leading to issues like antibiotic-associated diarrhea.

Choice B rationale:

Tetracyclines may cause permanent discoloration of the teeth in children. This is a well-known adverse effect of tetracycline antibiotics. It primarily occurs in children under the age of 8, whose teeth are still developing. Tetracyclines can bind to calcium ions in teeth, leading to a yellow or grayish discoloration. This is why tetracyclines are generally avoided in children and pregnant women.

Choice C rationale:

Tetracyclines can be used when penicillins are contraindicated. Tetracyclines and penicillins are different classes of antibiotics, and being contraindicated for one does not necessarily mean the other is also contraindicated. Tetracyclines can be an alternative for patients who cannot tolerate penicillins due to allergies or other contraindications.

Choice D rationale:

Tetracyclines are not contraindicated in children younger than 9 years. This statement is not accurate. Tetracyclines are contraindicated in children under the age of 8 due to the risk of tooth discoloration. After the age of 8, tetracyclines can be used in children, but caution is still required.

Choice E rationale:

Tetracyclines are not used to treat influenza. Influenza is caused by viruses, not bacteria, and tetracyclines are antibiotics that target bacteria. Influenza is typically treated with antiviral medications, such as oseltamivir (Tamiflu).