The nurse is taking a health history on a patient who has come to ...

[MirandaLo]

The nurse is taking a health history on a patient who has come to the clinic for a follow-up appointment.
 
  The patient states that the only medication she is taking is trimethoprim/sulfamethoxazole (Bactrim). Which statement made by the patient would most concern the nurse?
  a. I play softball on Thursdays.
  b. I sometimes feel tired.
  c. I am allergic to sulfa.
  d. I am taking this medication for my urinary tract infection.

Question 2

A patient is being treated with trimethoprim-sulfamethoxazole (Bactrim) for bronchitis. The patient has been taking captopril (Capoten) and spironolactone (Aldactone). The nurse would expect which of the following findings?
 
  a. Potassium level of 5.5 mEq/L
  b. Potassium level of 3.5 mEq/L
  c. Sodium level of 139 mEq/L
  d. Chloride level of 104 mEq/L

[softEldritch]

Answer to Question 1

ANS: C
The nurse should be most concerned that the patient is allergic to sulfa, because trimethoprim/sulfamethoxazole has a sulfa moiety and is contraindicated in patients allergic to sulfa.
Feeling tired is not a predominate concern.
The fact that the patient plays softball is not a concern, even though the potential exists for photosensitivity. The scenario does not specify whether she plays during the day or at night.
Taking trimethoprim/sulfamethoxazole for a UTI is appropriate for those who are not allergic to sulfa.

Answer to Question 2

ANS: A
The nurse would expect a potassium level of 5.5, because both captopril and spironolactone can cause hyperkalemia. Also, trimethoprim-sulfamethoxazole can cause hypersensitivity reactions in patients taking thiazide and loop diuretics and can affect the kidneys.
A potassium level of 3.5 is normal.
The sodium and chloride levels are normal.

[MirandaLo]

Excellent

[diana chang]

TYSM