Nitrofurantoin (Macrodantin) is prescribed for an adolescent ...

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Nitrofurantoin (Macrodantin) is prescribed for an adolescent female patient with acute cystitis. What should the nurse include in the teaching for this patient? (Select all that apply.)
 
  a. Make sure you tell your prescriber if you might be pregnant.
  b. If you experience any tingling or numbness, stop taking the drug and call the clinic immediately.
  c. Headaches and drowsiness can occur and are mild side effects.
  d. You should not take sulfonamides while taking this medication.
  e. Your urine may have a brown tinge while you are taking this drug.

Question 2

A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin.
 
  The nurse knows that the best alternative for treating this urinary tract infection is with:
  a. cephalexin (Keflex).
  b. fosfomycin (Monural).
  c. methenamine (Hiprex).
  d. nitrofurantoin (Macrodantin).

[amandalm]

Answer to Question 1

ANS: A, B, C, E
Nitrofurantoin is linked to serious birth defects and is not recommended during pregnancy. Tingling and numbness indicate neuropathy, which is a serious and often irreversible side effect. Central nervous system (CNS) side effects usually are mild and reversible. Sulfonamides cannot be taken with methenamine, because they can cause crystalluria. Patients' urine may have a brown tinge while they are taking this drug.

Answer to Question 2

ANS: C
Methenamine is an excellent second-line drug for this patient and is indicated because of the patient's multiple drug sensitivities. It is safe in pregnancy, and there is no drug resistance. Nitrofurantoin has potential harmful effects on the fetus and should not be used during pregnancy. Single-dose regimens are not recommended in pregnant women. Cephalexin can have cross-reactivity with amoxicillin.

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