Which statement is an important nursing implication in the management of a client who is taking trimethoprim/sulfamethoxazole for a urinary tract infection?
Extended periods outside in sunshine are important for vitamin D for this client
Clients should be told to expect brown urine while taking this medication
Follow-up with the Health Care Provider is unnecessary
Client should be monitored for anemia
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Crush injuries release myoglobin from damaged muscles, causing rhabdomyolysis. Myoglobin precipitates in renal tubules, obstructing them and leading to acute tubular necrosis, an intra-renal acute kidney injury. This toxic effect, combined with oxidative stress, impairs filtration, making this statement accurate for the pathophysiology of renal injury.
Choice B reason: Large IV fluid volumes are used to prevent renal injury in rhabdomyolysis by diluting myoglobin and maintaining perfusion. Fluid overload may cause pulmonary edema but does not typically cause pre-renal damage, which results from hypoperfusion. This statement is inaccurate, as fluids are protective, not harmful.
Choice C reason: Pain medications like NSAIDs can be nephrotoxic, causing intra-renal damage by reducing renal blood flow or causing interstitial nephritis. However, pre-renal damage results from hypoperfusion, not direct toxicity. In crush injuries, myoglobin is the primary cause, making this statement less accurate than myoglobin-related tubular damage.
Choice D reason: Significant blood loss causes pre-renal injury by reducing renal perfusion, not post-renal damage, which involves urinary obstruction. Crush injuries primarily cause intra-renal damage via myoglobin. This statement is inaccurate, as it misattributes the mechanism and type of renal injury in this context.
Correct Answer is A
Explanation
Choice A reason: Furosemide, a loop diuretic, inhibits the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, preventing sodium and water reabsorption. This increases urine output significantly, often within minutes, making it highly effective for conditions like edema or heart failure, producing a rapid diuresis of up to 20% of filtered sodium.
Choice B reason: Spironolactone, a potassium-sparing diuretic, inhibits aldosterone in the distal tubule, reducing sodium reabsorption and increasing urine output. However, its diuretic effect is weaker than furosemide, as it affects only 2-3% of filtered sodium. It is primarily used for managing hyperaldosteronism or potassium retention, not rapid urine flow increase.
Choice C reason: Hydrochlorothiazide, a thiazide diuretic, inhibits sodium-chloride reabsorption in the distal convoluted tubule, increasing urine output. Its effect is milder than furosemide, impacting about 5-10% of filtered sodium. It is commonly used for hypertension but is less potent for rapid diuresis in conditions requiring significant urine flow.
Choice D reason: Mannitol, an osmotic diuretic, increases urine flow by preventing water reabsorption in the proximal tubule and loop of Henle. It is effective in acute settings like cerebral edema but less commonly used for routine diuresis compared to furosemide, which has a broader and more rapid effect on urine output.
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