A nurse is providing education to a client newly prescribed Sulfasalazine and Azathioprine for refractory ulcerative colitis. Which of the following statements by the client indicates that further teaching is required?
“I should avoid being outside in crowds while on these medications.”
“It may take several weeks for me to feel the effects of the medications.”
“I should notify my provider if I experience fevers.”
“I should go to the emergency room immediately if my urine turns orange.”
The Correct Answer is D
A. Avoiding crowds is appropriate, as both Sulfasalazine and Azathioprine can suppress the immune system, increasing the risk of infection.
B. It is correct that it may take several weeks for these medications to show effects, especially with Sulfasalazine. This is a reasonable statement.
C. Notifying the provider if the client experiences fevers is important because it could be a sign of infection, which is a potential side effect of Azathioprine, an immunosuppressive drug.
D. Orange urine is a common side effect of Sulfasalazine and is harmless. The client should not go to the emergency room for this symptom, as it is a known and expected side effect. Therefore, the statement about going to the emergency room indicates a need for further teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Furosemide (Lasix) is a loop diuretic that typically causes the loss of potassium through the urine, thus putting clients at risk for hypokalemia, not hyperkalemia.
B. Spironolactone (Aldactone) is a potassium-sparing diuretic, meaning it helps the body retain potassium. As a result, it can lead to hyperkalemia, especially in patients with kidney dysfunction or when used with other medications that increase potassium levels.
C. Sodium polystyrene sulfate (Kayexalate) is used to treat hyperkalemia by exchanging sodium for potassium in the intestines, thus lowering potassium levels. It does not contribute to hyperkalemia.
D. Insulin does not directly cause hyperkalemia; in fact, insulin administration can lower potassium levels by driving potassium into cells.
Correct Answer is A
Explanation
A. Antihypertensive medication is not a priority intervention for a client with a blood glucose level of 620 mg/dL, which indicates hyperglycemia, likely due to diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). The focus should be on correcting the hyperglycemia and preventing complications like dehydration or electrolyte imbalances.
B. Fluid replacement is essential to treat dehydration caused by hyperglycemia, as high blood glucose levels cause osmotic diuresis.
C. Potassium laboratory monitoring is crucial because insulin treatment can shift potassium into cells, potentially causing hypokalemia, so monitoring is necessary during treatment.
D. Insulin IV infusion is necessary to lower the blood glucose level in clients with severe hyperglycemia, such as in DKA or HHS.
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