A patient who had surgery 6 days earlier has developed a urinary ...

[lak]

A patient who had surgery 6 days earlier has developed a urinary tract infection, for which the prescriber has ordered nitrofurantoin (Macrodantin). The nurse is providing patient education about the medication.
 
  What should the nurse include in the teaching? (Select all that apply.)
  a. We will need to monitor your creatinine clearance levels.
  b. It would be best to take your meds on an empty stomach.
  c. Your urine may have a brown tint.
  d. You may experience constipation.
  e. You may experience a headache.

Question 2

A patient has been taking nalidixic acid (NegGram) for recurrent urinary tract infections. While reviewing the patient's medications, that nurse notes that the patient also has been taking warfarin (Coumadin) and alerts the prescriber.
 
  What change to the medication regimen would the nurse anticipate?
  a. Increase in the warfarin
  b. Decrease in the warfarin
  c. Increase in the nalidixic acid
  d. Decrease in the nalidixic acid

[Jane]

Answer to Question 1

ANS: A, C, E
Creatinine clearance levels should be monitored, because if the levels are too low, toxicity may occur. Nitrofurantoin imparts a harmless brown color to the urine, and it can cause multiple neurologic effects, such as headache, vertigo, and drowsiness.
Nitrofurantoin should be taken with meals to minimize gastrointestinal (GI) upset (nausea, vomiting and diarrhea).
The patient will experience diarrhea, not constipation.

Answer to Question 2

ANS: B
Nalidixic acid can intensify the effects of warfarin, and a reduction in the warfarin dosage may be needed.
Nalidix acid increases warfarin levels, thus it would be inappropriate to increase the dose.
Concurrent administration of nalidixic acid and warfarin does not affect nalidixic levels.

[lak]

Thanks for the timely response, appreciate it

[bassamabas]

Excellent