A patient who has been taking nalidixic acid (NegGram) for a ...

[Mr. Wonderful]

A patient who has been taking nalidixic acid (NegGram) for a urinary tract infection is now diagnosed with a respiratory infection. The patient asks, Will the nalidixic acid I'm taking cover both infections? Select the nurse's best response.
 
  a. The drug you are on will cover you for organisms in the respiratory tract as well. Continue taking it as prescribed.
  b. To cover the respiratory tract infection, you will need two additional doses of this medication.
  c. This drug can actually cause respiratory tract infections, so you should discontinue it immediately.
  d. The drug you're taking has no action outside the urinary tract. You will need an additional antibiotic for the respiratory tract infection.

Question 2

For which of the following patients would nitrofurantoin (Macrodantin) be contraindicated?
 
  a. Patient with a urine phosphate of 0.9 gm/24 hr
  b. Patient with a urine specific gravity of 1.024
  c. Patient with bacteria in the urine
  d. Patient with a creatinine clearance of 38 mL/min

[potomatos]

Answer to Question 1

ANS: D
Nalidixic acid is approved only for urinary tract infections. The drug is not useful against infections outside the urinary tract.
Nalidixic acid will not cover a respiratory tract infection.
Additional doses are not required.
The medication should not be discontinued.

Answer to Question 2

ANS: D
Nitrofurantoin should not be administered to individuals with renal impairment, as indicated by a creatinine clearance of less than 40 mL/min. In the absence of good renal function, levels of nitrofurantoin in the urine are too low to be effective. Also, renal impairment reduces nitrofurantoin excretion, causing plasma levels of the drug to rise, posing a risk of systemic toxicity.
A urine phosphate of 0.9 is within acceptable limits as is a specific gravity of 1.024.
Macrodantin is indicated for cystitis and UTI, thus bacteria in the urine would be expected and not a contraindication.

[Mr. Wonderful]

TY

[potomatos]

You're welcome