An older adult is admitted to the emergency department after working outside during extremely high temperatures. The client is lethargic and diagnosed with heat stroke. Which intervention should the nurse implement?

Choice A reason: Trimethoprim/sulfamethoxazole does not require extended sun exposure. In fact, it causes photosensitivity, increasing sunburn risk, so patients should avoid prolonged sunlight. Vitamin D synthesis is unrelated to this antibiotic’s mechanism or side effects, making this statement inaccurate and potentially harmful for patient safety.

Choice B reason: Trimethoprim/sulfamethoxazole does not typically cause brown urine. Brown urine may indicate hematuria or other conditions, but it is not a common side effect of this drug. The medication may cause gastrointestinal upset or rash, but urine discoloration is not expected, making this statement inaccurate.

Choice C reason: Follow-up with a healthcare provider is necessary to ensure UTI resolution and monitor for side effects like rash, renal impairment, or rare hematologic effects. This statement is inaccurate, as lack of follow-up could miss treatment failure or complications, undermining effective management of the infection.

Choice D reason: Trimethoprim/sulfamethoxazole can cause bone marrow suppression, leading to anemia, particularly in patients with folate deficiency or prolonged use. Monitoring complete blood counts is critical to detect hemolytic anemia or other hematologic toxicities, making this statement accurate and essential for safe patient management during treatment.

Choice A reason: Acetaminophen reduces fever by acting on the hypothalamic thermoregulatory center but is ineffective for heat stroke, a hyperthermic emergency caused by environmental heat overload. It does not address core temperature elevation or systemic effects like dehydration and organ dysfunction, making it inappropriate for immediate heat stroke management.

Choice B reason: Removing the client’s clothing facilitates evaporative and convective cooling, critical in heat stroke where core body temperature exceeds 40°C. This intervention enhances heat dissipation from the skin, reducing the risk of organ damage from hyperthermia. It is a primary nursing action to lower body temperature effectively and safely.

Choice C reason: Placing a client with heat stroke in a hot bath would exacerbate hyperthermia, worsening organ damage and cardiovascular strain. Heat stroke requires rapid cooling via cold water immersion or evaporative methods, not additional heat exposure, making this intervention dangerous and contraindicated in this life-threatening condition.

Choice D reason: Encouraging oral fluids like cold water is inappropriate for a lethargic heat stroke patient, who may have impaired swallowing or consciousness, risking aspiration. Intravenous fluids are preferred to correct dehydration and electrolyte imbalances safely, as oral intake does not address the urgent need for rapid cooling and systemic stabilization.